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Pharm EXAM 2 > chapter 9- coagulation > Flashcards

chapter 9- coagulation Flashcards

1
Q

what is hemostasis

A

halt of blood
-natural process in response to injury to tissue

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2
Q

how does hemostasis occur

A

vasoconstriction, formation of a platelet plug, activation of clotting factor, reparation of the opening in a damaged vessel

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3
Q

what do plasminogen and fibrin do

A

form a clot

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4
Q

what does Plasmin do

A

dissolves a clot

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5
Q

what do capillaries do

A

connect veins and arteries

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6
Q

what organ affects clotting the most

A

the liver

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7
Q

define intrinsic and extrinsic

A

I: blood vessel damage
E: tissue damage

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8
Q

what is thrombogenisis

A

formation of and dissolving of clot

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9
Q

what is arterial thrombosis, an incomplete blockage, complete blockage and the cause.

A

obstruction of arterial blood flow
-caused by damaged arterial endothelium, causing platelet activation
In: deficient blood flow, causing ischemia
C: obstruction, causing necrosis
Causes: atherosclerosis, HTN, turbulent arterial blood flow

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10
Q

what is venous thrombosis and DVT and the cause

A

result of venous stasis, thrombin, and procoagulant substances become concentrated
-easily detached
DVT, PE if detached
-common in lower extremities, will block the right side of the heart
Assessment: pain redness, swollen, hot, some will be asymptomatic
caused by: decreased activity

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11
Q

what is atherosclerosis

A

elevated lipid levels, causing plaques to form
-progressive
-causes MI and TIA, CVA and strokes

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12
Q

what is TIA

A

transient ischemic effect, occurs before CVA and strokes

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13
Q

what are anticoagulants used for

A

thrombotic disorders, prevent venous thrombus
-thrombophlebitis, DVT and PE, A fib

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14
Q

what are antiplatelets used for

A

prevent arterial thrombosis

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15
Q

what are thrombolytics used for

A

dissolve thrombi and limit tissue damage

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16
Q

what is thrombophlebitis

A

vein inflammation

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17
Q

main adverse effect of anticoagulants

A

bleeding

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18
Q

challenge with anticoagulants

A

dosing for therapeutic levels is challenging

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19
Q

what do you have to do if administering IV heparin

A

draw labs every six hours until the therapeutic dose is achieved
-aPTT/PTT
-levels should be 60-80

20
Q

the primary use for SQ heparin

A

DVT prevention for in-bed restricted Pts, 5000u is a common dose

21
Q

what is the antidote for heparin

A

protamine sulfate

22
Q

why is enoxaparin not used often

A

price

23
Q

what are warfarin levels measured by

A

INR and PT

24
Q

what is the antidote for warfarin, and what foods affect it

A

Vitamin K
-green leafy veggies, green tea, grapefruit juice, cranberry, alcohol

25
Q

how does fondaparinux work and how is it given

A

xa inhibitor
Sub Q and IV

26
Q

when is fondaparinux used and why only then

A

when heparin causes thrombocytopenia
PRICE

27
Q

how does dabigatran work and how is it administered

A

direct thrombin inhibitor, treats complications of Afib and stroke prevention
PO twice daily

28
Q

what is the antidote to dabigatran

A

idarucizumab

29
Q

why is dabigatran not used often

A

compliance issues with taking twice daily

30
Q

how does rivaroxaban work and how is it given

A

Xa inhibitor treats Afib complications and stroke and DVT prevention
PO once daily

31
Q

how does apixaban work and how is it given

A

The most common Xa inhibitor, used to treat Afib complications and stroke prevention
PO twice daily

32
Q

benefit of taking something other than warfarin

A

does not require regular testing, could lead to higher complications
-DO NOT STOP TAKING

33
Q

side effects other than bleeding for anticoagulants and possible complications

A

GI upset
Should not take NSAIDS
lots of dietary and drug interactions
such as… allopurinol, -cillin antibiotics, and birth control

34
Q

what is ecchymosis

A

increased bruising, bleeding episodes, dizziness, lightheadedness, hypotension, low hgb/hct, bloody urine, chest pain, SOB, hemoptysis
SIGNS DOSE IS TOO HIGH

35
Q

ways antiplatelets work

A

-inhibit activation
-inhibit adhesion
-inhibit aggregation
-inhibit the procoagulant activity

36
Q

how does clopidogrel work

A

inhibits ADP receptor on platelets
NO ANTIDOTE
Long first pass effect

37
Q

side effects of clopidogrel

A

rash and diarrhea

38
Q

what can clopidogrel be used with

A

aspirin

39
Q

how does aspirin work, and when is it used

A

thromboxane A2 inhibitor
prevents platelet aggregation and thrombus formation
81 mg, for MI, CVA, pts with prosthetic valves, and stents
NO ANTIDOTE

40
Q

how does abciximab work, and when is it used

A

glycoprotein antagonist prevents binding of fibrinogen, stopping platelet aggregation
for interventional procedures with aspirin and heparin

41
Q

how does cilostazol work and when is it used

A

phosphodiesterase inhibitor inhibits platelet aggregation and causes vasodilation
-used for intermittent claudication– pain caused by PAD/PVD
-know it is caused by this if it is relieved by rest
should improve within 2-4 weeks up to 12 weeks

42
Q

how does anagrelide work and when is it used

A

inhibits platelet aggregation induced by CAMp, phosphodiesterase, ADP, and collagen.
used to reduce platelet counts – thrombocythemia

43
Q

when are thrombolytic agents used

A

only in emergencies, large risk/benifit

44
Q

what labs are needed for thrombolytics

A

INR, aPTT, platelet count, fibrinogen

45
Q

how does alteplase work and when is it used

A

recombinant plasminogen activator
used for: post CVA, massive PE

46
Q

side effects to alteplase and other thrombolytics and when should it not be used

A

SYSTEMIC BLEEDING, kidney and liver function
-intracranial/spinal surgery
-severe hypotension
-active bleeding/coagulation issues/anticoagulation meds
-recent surgery
-stroke aneurysm in last 2 months

Pharm EXAM 2 (8 decks)

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