Coagulation Disorders Flashcards
steps of blood clotting in normal physiologic process
- vasoconstriction: reduce blood loss when injury occurs
- form platelet plug: platelets adhere to open areas and stick together
- coagulation cascade activates to convert plasma protein fibrinogen into fibrin
- clot retraction/repair: reduce size of clot, approximate edges of wound, fibroblasts proliferate to lay down collagen fibers
- fibrinolysis: clot remove by plasminogen, which is activated into plasmin which dissolves clot
regulation of coagulation
anticoagulants: antithrombin, protein C
tissue factor pathway inhibitor: inhibit extrinsic pathway
fibrinolysis: removal of clots
drug classess for anticoagulation
thrombolytics
anticoagulants
antithrombotics/antiplatelet
indications for anticoagulants
DVT
PE
A fib
MI
arteriosclerosis
acute coronary syndrome
stroke
artificial heart valve
hemodialysis
chronic renal failure
CABG
adverse effects of anticoagulants
increased/excess bleeding
list anticoagulant drugs
warfarin: vitamin K antagonist
heparin
LMWH
dabigatran: direct thrombin inhibitor
Factor Xa inhibitors: fondaparinux
list anti thrombotics
aspirin: COX inhibitor
Plavix: ADP receptor inhibitors
tirofiban, abciximab: glycoprotein inhibitors
list thrombolytics
tPA
reteplase
tenectplase
hemostatic drugs function
promote clot stability
prevent excess bleeding
includes tranexamic acid, aminocaproid acid
vitamin K function
antidote to warfarin overdose/excess anticoagulation
warfarin MOA
vitamin K antagonist
antagonise liver synthesis of vitamin K dependent clotting factors
indications for warfarin
if pt will be on anticoagulation long term
VTE
acute Afib
side effects of warfarin
hemorrhage
fetotoxic
many drug interactions
INR
normal: 1
target in anticoagulation differs: 2.5-3.5
PT considerations on warfarin
bruising
risk of bleeding
fall risk
INR monitoring