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Pharmacology > Chapter 28- Coagulation Modifier drugs > Flashcards

Chapter 28- Coagulation Modifier drugs Flashcards

1
Q

Anticoagulant/ Mech of Action

A

A substance that prevents or delays coagulation of the blood.
Varies depending on drug. Do not lyse existing clots. Ex) heparin and low-weight-molecular heparins (LWMHs)-Turn off coagulation pathway and prevent clot formation. Warfarin (Coumadin)

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2
Q

Antifibrinolytic drug

A

A drug that promotes the formation of clots through prevention of the lysis of fibrin. Prevention and treatment of excessive bleeding. Hardly ever used.
ex) desmopression (DDAVP), similar to antidiuretic hormone (ADH), also used in the treatment of diabetes insipidus.

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3
Q

Antiplatelet drug

A

A drug that prevents platelet plugs from forming; this effect can help prevent cardiovascular disease such as MI and strokes
Ex) acetylicyclic acid (Aspirin), clopidogrel (Plavix), eptifibatide (Integrillin)

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4
Q

Antithrombin III (AT-III)

A

A substance that inactivates three major activating factors of the clotting cascade; activated II(thrombin), activated X, and activated IX

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5
Q

B-Hemolytic streptococci (group A)

A

The pyogenic streptococci of group A that cause hemolysis of RBC in blood agar in the lab setting

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6
Q

Clot

A

Insoluble solid elements of blood (cells, fibrin, threads) that have chemically separated from the liquid (plasma) component of the blood.

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7
Q

Coagulation

A

The sequential process by which the multiple coagulation factors of the blood interact in the coagulation cascade, ultimately forming an insoluble fibrin clot.

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8
Q

Coagulation cascade

A

The series of steps beginning with the intrinsic or extrinsic pathways of coagulation and proceeding through the formation of a fibrin clot.

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9
Q

Deep Vein Thrombosis (DVT)

A

The formation of a thrombus in one of the deep veins in the body, most commonly the iliac and femoral veins.

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10
Q

Embolus

A

A blood clot (thrombus) that has been dislodged from the wall of a blood vessel and is travelling throughout the bloodstream.

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11
Q

Fibrin

A

A stringy, insoluble protein produced by the action of thrombin on fibrinogen during the clotting process; a major component of blood clots or thrombi

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12
Q

Fibrinogen

A

A plasma protein that is converted into fibrin by thrombin in the presence of calcium ions

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13
Q

Fibrinolysis

A

The continual process of fibrin decomposition produced by the actions of the enzymatic protein fibronlysin.

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14
Q

Fibrinlytic system

A

An area of the circulatory system undergoing fibrinolysis

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15
Q

Fibrin-specificity

A

Property of newer thrombolytic drugs to activate plasminogen to plasmin in the presence of established clots having fibrin threads

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16
Q

Hemorheological drug

A

A drug that alters the function of platelets without compromising their blood-clotting properties.

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17
Q

Hemostasis

A

The process that halts bleeding after injury to a blood vessel

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18
Q

Hemostatic

A

A procedure, device, or substance that arrests the flow of blood

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19
Q

Plasmin

A

The enzymatic protein that breaks down fibrin into fibrin degradation products; it is derived from plasminogen

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20
Q

Plasminogen

A

A plasma protein that is converted to plasmin

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21
Q

Pulmonary embolus (PE)

A

The blockage of a pulmonary artery by foreign matter such as fat, air, tumour, or a thrombus that usually arises from a peripheral vein.

22
Q

Stoke

A

Occlusion of the blood vessels of the brain by an embolus, thrombus, or cerebrovascular hemorrhage, resulting in schema of the brain tissue.

23
Q

Thromboembolic event

A

An event in which a blood vessel is blocked by an embolus carried in the bloodstream from the site of its formation

24
Q

Thrombolytic drug/ Mech of Action

A

Drugs that break down, or lyse, preformed clots.
ex) Tissue plasminogen activator, APSAC, alteplase (t-PA, Activase) & tenecteplase (TNKase)

Activate the fibrinolytic system to break down the clot in the blood vessel quickly. Activate plasminogen, which digests fibrin. Re-establish blood flow to heart muscle.

25
Q

Thrombus

A

Technical term for blood clot (plural: thrombi); an aggregation of platelets, fibrin, clotting factors, and the cellular elements of the blood that is attached to the interior wall of a vein or artery, sometimes occluding the lumen of the vessel.

26
Q

Tissue plasminogen activator

A

A naturally occurring plasminogen activator secreted by vascular endothelial cells in the walls of the blood vessels. Thrombolytic drugs are based on this component.

27
Q

Substances promoting coagulation

A

Platelets, Von Willebrand factor, Activated clotting factors, tissue thromboplastin

28
Q

Anticoagulants Indications

A

Atrial fibrillation, mechanical heart valves, major orthopaedic surgery (because of immobility)

29
Q

Anticoagulants Contraindications

A

Acute bleeding process, Thrombocytopenia (low platelets), warfarin is strongly contraindicated in pregnancy

30
Q

Anticoagulants adverse effects

A

Bleeding, N/V, Abdo cramps, Thrombocytopenia

31
Q

Anticoagulants Interactions

A

Coumadin interacts with lots!

32
Q

Heparin

Lovenox

A

Monitored by activated partial thromboplastin times (aPTTs), available in parenteral form, short half life (1-2hrs), antidote= protamine sulphate.

Lovenox is a low-weight-molecular heparin used in pregnancy

33
Q

Warfarin (Coumadin)

A

Given orally only. Monitored by prothrombin time (PT) and INR. Antidote= Vitamin K

34
Q

Antiplatelet Indications

A

Antithrombotic effects-reduce risk of fatal and nonfatal strokes

35
Q

Antiplatelet Adverse effects

A

Bleeding

36
Q

Antiplatelet Contraindications

A

Allergy, Thrombocytopenia, GI ulcer, Vitamin K deficiency, Recent Stroke

37
Q

Antiplatelet interactions

A

NSAIDS like ibuprofen. Produces additive antiplatelet activity and increased bleeding potential

38
Q

Antifibrinolytic Indications

A

Prevention and treatment of excessive bleeding

39
Q

Antifibrinolytic Contraindications

A

Disseminated intravascular coagulation (DIC)

40
Q

Antifibrinolytic Adverse Effects

A

Many including death

41
Q

Antifibrinolytic Interactions

A

Estrogens or oral contraceptives. Lithium

42
Q

Thrombolytic Indications

A

MI, occlusion of shunts or catheters, stroke

43
Q

Thrombolytic Contraindications

A

Drug allergy

44
Q

Thrombolytic Adverse Effects

A

Bleeding, N/V, hypotension, anaphylactoid reactions, cardiac dysrhythmias

45
Q

Thrombolytic Interactions

A

Increased bleeding tendency with concurrent use of anticoagulant, antiplatelet

46
Q

Heparin: Nursing Implications

A

IV doses-double check with another nurse.
SubQ given SubQ and given in areas of deep subcutaneous fat and site should be rotated. Do not give SubQ doses within 5cm of umbilicus and do not aspirate or massage injection site.
Protamine sulphate given as antidote

47
Q

LWMHs: Nursing Implications

A

SubQ in Abdomen
Rotate Injection sites
Protamine sulphate given as antidote

48
Q

Warfarin: Nursing Implications

A

May be started while the PT is still on heparin until PT/INR levels indicate adequate anticoagulation “bridging”.
Vitamin K is antidote
Increased bleeding may occur with Garlic, Ginger, Gingko, Ginseng, Feverfew and Capsicum pepper

49
Q

Thrombolytic: Nursing Implications

A

Montior IV sites for bleeding, redness, pain.

Observe for signs of internal bleeding (decreased BP, restlessness, increased pulse, confused)

50
Q

Nursing Implications

A

Monitor for signs of excessive bleeding ex)nosebleeds

Monitor for adverse effects

Pharmacology (17 decks)

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