Coagulation modifier drugs

Question 1

What is the meaning of hemostasis and coagulation?

Answer 1

This is the general term that describes stopping bleeding. Coagulation is hemostasis that happens as a physiological clotting of blood

Question 2

What are the two clotting pathways and what is the result of the coagulation system?

Answer 2

The two pathways are the extrinsic and intrinsic pathway and they result in the production of fibrin

Question 3

What is the fibrinolytic system and what is fibrinolysis?

Answer 3

This is a system that starts the breakdown of clots and balances the clotting process. Fibronolysis is when a thrombi is broken down to prevent excess clot formation

Question 4

What is hemophilia?

Answer 4

This is a rare genetic disorder where natural coagulation is limited or absent. These patients can bleed to death

Question 5

What are the 5 groups of coagulation-modifying drugs?

Answer 5

Anticoagulants, antiplatelet drugs, hemorheogiacal drugs, thrombolytic drugs, antifibrinolytic

Question 6

What are anticoagulant drugs, and what is an example?

Answer 6

They do not affect formed blood clots, but they prevent intravascular thrombosis by decreasing blood coagulability. An example is unfractionated heparin and low molecular weight heparins and enoxaparin

Question 7

What is the difference between unfractionated heparin and low molecular weight heparins?

Answer 7

The unfractionated is a larger molecule while low weight is a synthetic smaller molecule.

Question 8

When would we be using heparins?

Answer 8

They are used to prevent clot formation that can cause stoke, heart attack, pulmonary embolism or DVT. it is also used as a bridge therapy when a patient stops taking warfarin for surgery or invasive procedures

Question 9

What is warfarin?

Answer 9

Is is an anticoagulant that appears naturally and inhibits vitamin k synthesis so it prevents clot formation

Question 10

WHat do antithrombin drugs do and what is the main example?

Answer 10

They inhibit thrombin and the main example is dabigatran

Question 11

What is rivaroxaban?

Answer 11

This is a direct acting Xa inhibtiors

Question 12

Overall what do anticoagulants do?

Answer 12

They work on different parts of the clotting cascade to prevent intravascular thrombosis. THEY DO NOT LYSE EXISTING CLOTS

Question 13

Indications for anticoagulants?

Answer 13

Myocardial infarction, unstable angina, atrial fibrillation, indwelling devices.

Question 14

Adverse effects of anticoagulants?

Answer 14

BLEEDING, thrombocytopenia, warfarin shouldnt be given to pregnant women

Question 15

What is thrombocytopenia?

Answer 15

There are two types one is a drop in platelet count that is sudden and the other is a gradual fall in the count of platelets. Discontinue heparin for sudden and you can continue for the gradual reduction.

Question 16

What is used to treat thrombocytopenia

Answer 16

Argatroban

Question 17

How does protamine sulphate relate to heparin?

Answer 17

IV protamine sulphate can reverse the effects of 100 units of heparin

Question 18

How does vitamin k relate to coagulation

Answer 18

Vitamin K can hasten the return to normal coagulation so should be watched out for when giving warfarin

Question 19

What is heparin sodium?

Answer 19

It is a natural anticoagulant that comes from the lungs or intestinal mucosa of pigs.

Question 20

WHat are heparin flushes (heparin leo)

Answer 20

This is when a small vial of aqueous heparin IV flush solution is used

Question 21

What is warfarin sodium?

Answer 21

This is the most commonly prescribed anticoagulant and has a therapeutic INR of 2 to 3.5

Question 22

What is an example of a direct thrombin inhibitor, and what does it do?

Answer 22

This is a prodrug that is used for stroke and thrombosis prevention

Question 23

WHat are three examples of antiplatelet drugs?

Answer 23

Aspirin, clopidogrel bisulfate, eptifibatide

Question 24

What is the MOA of aspirin?

Answer 24

It prevents platelet aggregation and causes vasodilation

Question 25

WHat is the MOA of clopidogrel?

Answer 25

Affects platelet membranes, so they cant aggregate with each other

Question 26

What is the MOA of eptifibatide

Answer 26

It prevents platelet aggregation by blocking receptor protein on platelet membrane

Question 27

WHat are examples of thrombolytic drugs and what do they do?

Answer 27

They break down preformed clots in the coronary arteries. Examples are alteplase and tenecteplase

Question 28

What is the MOA of thrombolytic drugs?

Answer 28

They breakdown clots in blood vessels by mimicking the body process of clot destruction

Question 29

How do antifibrinolytic drugs work, and what is an example?

Answer 29

They prevent the lysis of fibrin which promotes clot formation. AN example is desmopressin acetate

Question 30

What is the main drug example of antifibrinolytic drugs, and what can it be used for?

Answer 30

Desmopressin acetate (DDAVP). It can be used in severe cases of surgical and postoperative hemostasis

Question 31

What should be done when administering intravenous heparin?

Answer 31

It should be double checked by another registered nurse

Question 32

What is a serious case protamine sulphate can be used for?

Answer 32

It can be used for severe cases of anticoagulation

Question 33

Can warfarin be administered with heparin? What would be an antidote for possible toxicity?

Answer 33

A patient can be given heparin if they are already taking warfarin until they have adequate levels of anticoagulation

Question 34

What are possible interactions for warfarin?

Answer 34

Capsicum pepper, garlic, ginger, ginkgo, st johns wort, feverfew

Question 35

What are some education points for patients on anticoagulant medication

Answer 35

They should have a medical alert bracelet, avoid foods high in vitamin k and consult their health provider before taking other drugs