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Nurs 251 Pharmacology 1 > Coagulation Modifier Drugs > Flashcards

Coagulation Modifier Drugs Flashcards

1
Q

What are the Coagulation Modifying drug Classes?

A

Anticoagulants
Antiplatelet
Hemorheological
Thrombolytic
Antifibrinolytic

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2
Q

What are anticoagulant drugs?

A

Drugs that work to inhibit the formation of a clot. Have no direct effect on a formed clot.

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3
Q

What is the MoA of anticoagulant drugs?

A

will vary depending on what drug is being used. All anticoagulants will work at different points in the coagulation cascade.

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4
Q

What are the Indications of Anti Coagulants?

A

Prevent clot formation to avoid MI, CVA, PE, DVT
bridge therapy for patient
discontinuing warfarin

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5
Q

What are the contraindications of Anticoagulant drugs?

A

Drug allergy, acute bleeding, pregnancy in warfarin,

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6
Q

Adverse Effects of Anticoagulants

A

Bleeding, heparin induced thrombocytopenia, nausea vomiting, abdominal cramps

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7
Q

Adverse Effects of Warfarin

A

Bleeding
lethargy
muscle pain
skin necrosis
Purple toes syndrome

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8
Q

How do you manage a Heparin overdose (toxic effects)?

A
  1. Stop the drug immediately (this may be enough in the cases of small amount of heparin)
  2. Administer an antidote such as Protamine sulphate for heparin (1 mg /100 units of unfractionated & 1 mg/ 1mg of LMWH)
  3. Replace RBCs in large amount of blood is lost
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9
Q

How do you manage a Warfarin overdose (toxic effects)?

A
  1. Discontinue Warfarin
  2. Administer the lowest amount of Phytonadione (vitamin K1) possible to speed up a return to healthy coagulation
    3.Use a heparin as an antithrombotic as Warfarin will not have a therapeutic effect for 7 days after being discontinued
  3. In severe bleeding cases transfuse human plasma/ clotting factors
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10
Q

What is Heparin induced Thrombocytopenia? Explain the Types.

A

Low levels of platelets in the body, is treated with thrombin inhibitors (argatroban)
Type 1: A gradual reduction of Platelets in the body. Heparin can normally be continued
Type 2: An acute fall of the number of platelets in the body (50% or >). Heparin must be discontinued.

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11
Q

What do PT and INR values represent?

A

These numbers measure the degree to which a persons blood coagulability has been reduced by a anticoagulant. 0.8-1.2 without warfarin/ 2-3.5 on warfarin

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12
Q

List the Anticoagulant Drugs you need to know for the Exam

A

Heparin (unfractionated)
LMWH (enoxaparin)
Warfarin (coumadin)
Dabigatran (synthetic antithrombin)
Rivaroxaban (direct acting Xa inhibitor)

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13
Q

What is the difference between UFH and LMWH

A

LMWH is cleaved off of UFH and has a longer HL meaning it can be taken less often, better bioavailability, and greater affinity for factor Xa

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14
Q

Pharmacokinetics of Warfarin

A

Route: PO
Onset of Action: 24-72hrs
Peak: 4hrs
HL:0.5-3 days
Duration of Action:2-5 days

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15
Q

What are Antiplatelet drugs?

A

Drugs that act to prevent the binding of platelets to the site of blood vessel injury

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16
Q

What is the MoA of Antiplatelet drugs>

A

Antiplatelet drugs work by interfering with various stages of platelet activation and aggregation, ultimately preventing the formation of blood clots.
ASA: inhibits platelet aggregation and vasoconstriction
Clopidogrel: Alters platelet membrane so that it can no longer receive signal to aggregate and form plug
Eptifibatide: Block the receptor protein in the platelet membrane

17
Q

what are the Indications of Antiplatelet drugs?

A

Antithrombotic effects
(reduces the formation of Blood clots)

18
Q

What are the Contraindications of Antiplatelet drugs?

A

known drug allergy, active bleeding, traumatic injury, leukemia, GI ulcer, vitamin K deficiency, recent stroke. ASA in children with flu like symptoms

19
Q

What are the adverse effects of Antiplatelet drugs?

A

Can induce bleeding

20
Q

List the Antiplatelet Drugs you need to know for the Exam

A

ASA
Clopidogrel
Eptifibatide

21
Q

What are Thrombolytic Drugs?

A

Drugs that cause the breakdown of clots in the coronary arteries

22
Q

What is the MoA of Thrombolytic drugs?

A

Enhances the effect of the natural fibrinolytic system to break down clots, by activating plasminogen to plasmin which is proteolytic enzyme

23
Q

What are the Indications of Thrombolytic drugs?

A

Acute MIs
Arterial thrombi
DWT Occlusion of shunts/ catheters
Ischemic stroke

24
Q

What are the Contraindications of Thrombolytic Drugs?

A

allergy, major surgery, trauma, bleeding, drugs that alter clotting,

25
Q

what are the Adverse effects of Thrombolytic drugs?

A

Bleeding, nausea, vomiting, hypotension, cardiac dysrhythmias

26
Q

List the Thrombolytic drugs you need to know for the Exam

A

Alteplase, Tenecteplase

27
Q

What are Antifibrinolytic drugs?

A

Drugs that prevent the lysis of fibrin which results in enhanced clot formation

28
Q

What is the MoA of Antifibrinolytic drugs?

A

depends on the drug
desmopressin acetate: increases von Willebrand factor helping anchor the clot to vessel

29
Q

What are the indications of Antifibrinolytic drugs?

A

Used in the prevention and treatment of severe bleeding

30
Q

What are the Contraindications of Antifibrinolytic drugs?

A

allergy, impaired intravascular coagulation

31
Q

What are the Adverse effects of Antifibrinolytic drugs?

A

dysthymias, orthostatic hypotension, bradycardia, convulsions, hallucinations

32
Q

List the Antifibrinolytic drugs you need to know for the exam

A

desmopressin acetate

33
Q

What are nursing implications for Coagulation Modifying drugs?

A

Assessing pt vitals, medical hx, bleeding hx, and potential contraindications, teach pt to follow strict guidelines, monitor for bleeding, pt should wear medical alert braclet, avoid foods high in vitamin K (tomatoes, leafy green veggies)

34
Q

What are Nursing Implications of Heparin

A

Ensuring dose is double checked, ensure med is given IV, do not massage the injection site, give injection 5 cm away from umbilicus, stoma, scars…etc., do not aspirate med, effect will be immediate, protamine sulphate is the antidote

35
Q

what are nursing implications for Warfarin ?

A

may be started while pt is still on heparin, full therapeutic effect will take several days, monitor PT/INR, antidote is vitamin K, G products may cause excessive bleeding

36
Q

Name the G products + the two others that may cause bleeding

A

Capsicum pepper
Garlic
Ginger
Ginkgo
St. John’s wort
Feverfew

Nurs 251 Pharmacology 1 (7 decks)

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