Coagulation Meds Exam 3 Flashcards
MOA for heparin
prevents clotting by activating antithrombin –> indirectly inactivates thrombin & factor Xa
MOA for enoxaparin (Lovenox)
prevents clotting by activating antithrombin –> inactivates factor Xa
Side effects of heparin
bleeding
hematoma
anemia
thrombocytopenia
what is HIT
heparin induced thrombocytopenia
-low platelet count and increased development of thrombi –> caused by antibody development
what are nursing considerations for HIT
monitor platelet counts
stop heparin immediately if platelet count <100,000/mm^3
what is the antidote for heparin
protamine sulfate
side effects of enoxaparin (Lovenox)
bleeding, thrombocytopenia, HIT
antidote for enoxaparin
protamine
nursing considerations for enoxaparin
DO NOT GIVE WITH HEPARIN pregnant women can receive slower onset of heparin but LONGER half-life pre-filled syringes rotate injection sites
black box warning for enoxaparin
potential spinal hematoma if patient has epidural catheter
MOA for warfarin
vitamin K inhibitor - prevents synthesis of four coagulation factors (VII, IX, X, prothrombin)
indications for warfarin
prevention VTE/DVT/PE
thrombotic events for patients with afib or heart valves
reduce recurrence of TIA or MI
SE of warfarin
BLEEDING
lethargy
muscle pain
purple toes
antidote for warfarin
Vitamin K
nursing considerations for warfarin
cannot give to pregnant women or breastfeeding women
monitor and TEACH for signs of bleeding
onset is 24 hours
-duration is 2-5 days
MOA for apixaban & rivaroxaban
direct inhibitor of factor Xa
indications for apixaban & rivaroxaban
prevent strokes in patients with afib
post-op thrombo-prophylaxis
treat DVT & PE
adverse effects of apixaban & rivaroxaban
bleeding, hematoma, dizziness, rash, GI distress, peripheral edema
black box warning for apixaban & rivaroxaban
spinal hematomas
risk of thrombosis if drugs abruptly stopped
nursing considerations for apixaban & rivaroxaban
drug interactions - no grapefruit no routine monitoring required do not give with other anticoagulants watch liver antidote: andexxa (giving factor Xa)
MOA of aspirin
antiplatelet
NSAID
blocks prostaglandin synthesis through the COX enzyme pathways - through this mechanism also BLOCKS PLATELET AGGREGATION
prevents platelets from clumping together
indications for aspirin
prevent/threat MI, prevent ischemic stroke
SE for aspirin
GI (n/v), drowsiness/confusion, bleeding
nursing considers for aspirin
dont crush enteric coated
OTC medication
reye’s syndrome: children with a virus NO ASPIRIN
antidote for aspirin
DDAVP
clopidogrel & ticagrelor MOA
antiplatelet ADP inhibitor
indications for clopidogrel and ticagrelor
reduce risk of stroke
prophylaxis of TIAs
post MI
SE of clopidogrel and ticagrelor
chest pain, edema, flu-like symptoms, abdominal pain, diarrhea, nausea, epistaxis (nose bleed), rash, pruritus
BLACK BOX warning for clopidogrel
patients with certain genetic abnormalities who may have higher rate of CV events due to reduced conversion to its active metabolite
BLACK BOX for ticagrelor
increased bleeding risk with aspirin doses over 100 mg
what is the antidote for clopidogrel and ticagrelor
DDAVP
