Coagulation & Hyperlipidemia

Question 1

Blood coagulation required to prevent excessive hemorrhaging from damaged blood vessels is referred to as..?

Answer 1

Hemostasis

Question 2

Thrombus formation as a result of overactive clotting is referred to as..?

Answer 2

Thrombogenesis

Question 3

Treatment for thrombus formation (3)

Answer 3

Anticoagulants & Antiplatelets (prevent clot formation)
Fibrinolytics (remove clots)

Question 4

To prevent atherosclerosis, plasma lipid levels are _____

Answer 4

Decreased

Question 5

Tissue Plasminogen Activator (t-PA)

Answer 5

Breaks down a clot - Converts plasminogen to plasmin (fibrinolysin) to initiate break down of fibrin mesh

Question 6

Drugs used to control the synthesis and function of clotting factors. Used to prevent clot formation in venous system

Answer 6

Anticoagulants

Question 7

Inhibit abnormal platelet activity by preventing thrombus formation in arteries that could lead to MI or ischemic CVA

Answer 7

Antiplatelets

Question 8

Facilitate destruction of clots which re-establishes blood flow through vessels

Answer 8

Fibrinolytics

Question 9

Primary drug in initial treatment of venous thrombosis. Effects seen almost immediately. Administered 2x/day parenterally (IV)

Answer 9

Heparin (Anticoagulants)

Question 10

Low molecular weight heparin

Answer 10

Ending “-parin” or Lovenox
Administered 1x/day subcutaneously into fat tissue
Used in patients having surgery or at risk for DVTs

Question 11

Primary drug used in long-term prevention of venous thrombosis

Answer 11

Warfarin (Coumadin)

Question 12

Mechanism of Warfarin

Answer 12

Interferes with Vitamin K metabolism in liver & impairs hepatic synthesis of clotting factors

Question 13

Acceptable clotting INR range for long-term Warfarin (Coumadin) use?

Answer 13

2-3

Question 14

Adverse effects of Anticoagulants

Answer 14

Hemorrhage, thrombocytopenia - severe autoimmune situation, GI distress, skin reactions

Question 15

Drugs primarily used to prevent formation of arterial clots

Answer 15

Antiplatelets - Aspirin, ADP blockers, Glycoprotein IIb-IIIa blockers

Question 16

Effective dose of Aspirin

Answer 16

75-325 mg/day

Question 17

Mechanism of Aspirin on Platelets

Answer 17

Irreversible effect - Inhibits platelet for remainder of life (7-8 days)
Suppresses natural platelet aggregation
Assists in preventing ischemic strokes, but may increase risk of hemorrhagic stroke

Question 18

ADP Receptor Blockers (Plavix)

Answer 18

Blocks the chemical ADP that increases platelet activity and clotting – Results in reductions in clotting
Primary use: Prevent thrombosis in pts at risk of MI or ischemic stroke

Question 19

Glycoprotein IIb-IIIa Receptor Blockers

Answer 19

Inhibit ability of fibrinogen to activate platelets by blocking receptor cite on platelet membrane
MOST POWERFUL inhibitors of platelet activity
Used in patients undergoing angioplasty or other interventions

Question 20

Adverse effects of Anti-platelet drugs

Answer 20

Increased risk of bleeding, hypotension, GI distress, gastric irritation (aspirin)

Question 21

Fibrinolytics

Answer 21

Essential in treating MI – Reestablishes blood flow at onset of MI
Also used for peripheral artery clot dissolving, PEs, and occluded shunt/bypass grafts

Question 22

Effective window of fibrinolytics post-MI

Answer 22

12 hours after onset
Decreases morbidity and mortality by 50% if used within 1 hour of onset

Question 23

Adverse effects of fibrinolytics

Answer 23

Intracranial hemorrhage or additional bleeding due to stimulation of clot breakdown
Itching, Nausea, HA, allergic reactions/anaphylaxis

Question 24

Fibrinolytic CONTRAINDICATIONS

Answer 24

History of hemorrhagic stroke, active internal bleeding, other factors predisposing to hemorrhaging

Question 25

Clotting disorder characterized by the inability to synthesize adequate amounts of clotting factors. Causes joint problems due to intra-articular bleeding

Answer 25

Hemophilia

Question 26

Which vitamin may be responsible for inadequate clotting factor production by the liver?

Answer 26

Vitamin K

Question 27

Why do newborns require Vitamin K?

Answer 27

To prevent hemorrhaging - If they don’t have vitamin K they will not survive the first 5-8 days after birth

Question 28

Hyperlipidemia

Answer 28

Abnormally high concentration of lipids in blood – Causes atherosclerosis & cardiovascular disease

Question 29

What is the primary cause of cardiovascular disease?

Answer 29

Hyperlipidemia
Primary treatment - Statins

Question 30

Treatment of hyperlipidmia focuses on..?

Answer 30

Increasing HDL and decreasing LDL

Question 31

Statin Drugs (Lipitor, Crestor)

Answer 31

Reduce cholesterol production in liver cells. Cause breakdown of LDL and decreases triglycerides while increasing HDL

Question 32

Fibric Acids

Answer 32

Decrease triglyceride levels, produce increases in HDL, and help lower LDL levels

Question 33

Adverse effects of Lipid lowering drugs

Answer 33

GI distress, liver dysfunction, gallstones, pancreatitis, cardiovascular problems, neuromuscular problems (myopathy)
Can progress to rhabdomyolosis

Question 34

What should be done if rhabdomyolosis presents while on lipid lowering drugs?

Answer 34

Discontinue statin drug and rest for 4-6 weeks