Chapter 43 Anticoagulants Flashcards
What does hemostasis mean?
The slowing or stopping of blood flow
What does coagulation mean?
The formation of clot
What does fibrinolysis mean?
The breakdown of a blood clot
What does thrombus mean?
A blood clot obstructing flow in a vessel
What does thromboembolic disorder?
A disorder in which the body forms unnecessary clots
What does embolus mean?
A clot traveling through a vessel
What does thrombocytopenia mean?
Low platelet count
What does hemophilia mean?
Genetic bleeding disorder
What are the 3 drugs that we use to maintain or restore circulation?
Anticoagulants
Antiplatelets
Thrombolytics
What does anticoagulants do?
Prevent the formation of clots that inhibit circulation
What does anti platelets do?
Prevent platelet aggregation
What does thrombolytics do?
Attack and dissolve blood clots that have already formed
Thrombolyics are the only drug that help dissolve clots?
Yes
Anticoagulants are also known as antithrombotic drugs
Do they effect a blood clot that has already developed?
Nope
Labs for patients on anticoagulant therapy
What is prothrombin time?
Usually used when someone is on ??
PT measures the time it takes the plasma to clot
Warfarin
Labs for patients on anticoagulant therapy
INR used for?
Treatment goal is?
Used for standardized the PT test, making up for any difference in lab
2-3
Labs for patients on anticoagulant therapy
Activated partial thromboplastin time?
Used to monitor clotting times when on heparin
Warfarin -> PT(war)
Heparin -> PTT&APTT
Heparin can be given how? (2)
Usually we have to what?
Short half life of how long?
IV & SUB
Double check it with another nurse
1-2 hours
What is the antidote of heparin?
Protamine sulfate
Do you give over damage tissues?
Do you give 2 inches from umbilicus?
Heparin!
NO!!
Do you aspirate subq heparin shots?
Why?
No
Cause hematoma
What is low molecular weight heparin?
Think of lovenox
Less able to inactive thrombin
Prevent DVT & PE after surger
Lower risk of bleeding
(12 hour half life )
How much low molecular weight heparin given to?
Twice a day
It’s really low so patients get sent home in this
Don’t take aspirin with low molecular weight heparin why?
Because bleeding
Do you rub after administration of low weight molecular heparin?
NO!!!
Hematoma!!
What is an example of oral anticoagulants?
Warfarin!
What is the action of warfarin?
Inhibits hepatic synthesis of vitamin k
What is the antidote for warfarin?
Vitamin K
Can warfarin be started while the patient is still on heparin?
And how can this be safe to know?
Yes
Looking at the PT and INR levels
Do we use NSAIDS with warfarin?
No because highly protein bound and cause toxicity
How long does warfarin take to start working?
Takes a few days
Usually heparin and warfain at the same time, so when it’s time to go home, heparin is stopped and warfarin is used to take home
What’s the only thing pain relief or fever that people on anticoagulants can take?
Tylenol
It’s super important to tell dentist when they are using anticoagulants!!!
What is antiplatelets?
Used for?
- prevent thrombosis
- prevent MI & stroke
- prevention TIA
Suppress platelet aggregation
Single file line going through the blood vessels
What is an example of antiplatelye medications?
Aspirin
What is aspirin used for?
Prevent MI, thromboembolism and treatment of stroke
How much daily aspirin?
81mg
Plavix is another medication that’s antiplatelet
What is theombolytics?
Dissolving clots!!!
Bind to fibrin promoting conversion of plasminogen plasmin
What is thrombokytics used for?
PE,DVT, thrombolytic stroke
What are the 3 biggest adverse reaction of thrombolytics?
Anaphylactic
Dysrhyhmias
Hemorrhage