Coagulation Drugs Flashcards
1
Q
anticoagulant therapy
A
- primarily prophylactic, used when likelihood of clot formation is high
- prevents: fibrin deposits, extension of thrombus, thromboembolic complications
- action: delays blood coagulability
2
Q
heparin moa
A
- binds to antithrombin III and turn off the coagulation pathway to prevent clots from forming
- doesn’t dissolve clots, just prevents new one from forming
3
Q
heparin indications
A
- when there is a need for rapid anticoagulation
- surgery of heart and blood vessels
- hemodilaysis
- sudden arterial prophylaxis
- DVT/thrombophlebitis
- DVT prophylaxis
- Disseminated intravascular coagulation (DIC)
4
Q
heparin contraindications/caution
A
- preexisting conditions that would be life-threatening if bleeding occurred
- caution use in conditions with increased risk of bleeding
5
Q
heparin adverse effects
A
- bleeding/hemorrhage
- HIT (heparin induced thrombocytopenia)
6
Q
heparin coagulation studies
A
- prior to initiation obain baseline aPTT, PT, CBC, platelets
- dose based on weight
- 6 hours after start of infusion: check lab (ptt) again in opposite arm of infusion, adjust dose according to protocol repeat lab 6 hours later
7
Q
normal PTT
A
25-35 seconds
8
Q
therapeutic PTT
A
1.5 times normal… around 45-70 seconds
9
Q
administering heparin subq
A
- onset 20-60 min, 5000u every 6 hrs
- dont aspirate or rub site
- hold in place for 3 seconds
- double check dose with another nurse
10
Q
admin heparin iv
A
- onset immediate
- loading dose
- continuous infusion on pump; provided constant blood level and less risk for complications
11
Q
heparin implications
A
- watch for s/s of bleeding
- avoid shaving with razor, use electric
- limit needle sticks
- can precipitate HIT so look for sudden decrease in platelets
12
Q
heparin antidote
A
- protamine sulfate
- give slowly, no faster than 50mg over 10 minutes
- rapid infusion may cause hypotension, bradycardia, flushing
- may cause pulmonary edema and anaphylaxis
- check ACTs
13
Q
low molecular weight heparin drugs
A
- dalteparin
- enoxaparin
- tinxaparin
14
Q
low molecular weight heparin
A
- works similar to heparin but smaller and less protein-bound
- much more predictable anticoag response
- frequent lab monitoring not needed
- given subq only in abdomen, 2 inches from umbilicus
- often given is coumadin is effective
15
Q
warfarin moa
A
- inhibits vit. k synthesis, inhibites activation of several clotting factors in the liver, prevents clot formation, prevent
- prevents extension of formed clots and formation of new clots
16
Q
warfarin indications
A
- chronic a. fib
- prophylaxis and treatment of DVT
- mechanical heart valves
