coagulation

Question 1

aspirin

Answer 1

anti platelet drug
inhibits platelet aggregation by inhibiting synthesis of thromboxane A2
reduction of MI, stroke and vascular death in patients w atheroscerlosis
prevention of vascular ischemic events in patients w symptomatic atherosclereosis or ACS used in atrial fibrillation in patients unable to take vitamin k antagonists
nausea, dyspepsia, heartburn, epigastric pain, discomfort,GI bleeding, occult blood loss, dizziness, tinnitus
hearing loss acute aspirin toxicity
PO once a day
monitor Hgb, HCT, s&s of bleeding

Question 2

heparin

Answer 2

inhibits the formation of fibron clots inhibits the conversion of fibrinogen to fibrin
prevention of DVT/ pulmonary embolism

monitor aPTT, check the concentration double nurse check,
protamine sulfate - neutralizes heparin activity, dose dependent on heparin dose

Question 3

warfarin

Answer 3

acts in the liver to prevent synthesis of vitamin k
dependent clotting factors, competitive antagonist ro hepatic use of vitamin k
no effect on circulating factors or PLT function
anticoagulation effect takes 3-5 days after starting
most useful in long term prevention or management of venous thromembolic disorders
bleeding, N/V, abdominal pain, alopecia, urticaria, joint/muscle pain
monitor for bleeding, INR between 2-3
vitamin K - antidote

Question 4

alteplase

Answer 4

catalyzing conversion of plasminogen to plasmin
treat ischemic stroke
bleeding, symptomatic brain hemorrhage, headache, hypotension, rash, pain, fever
assess for cardiac dysrhymias, bleeding, check INR, aPTT, PLT and fibrogen prior to administration, monitor BP closely, administer w infusion device