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Pharmacology > Coagulation Modifiers > Flashcards

Coagulation Modifiers Flashcards

1
Q

Intrinsic Pathway has clotting factors convert _______ to ______

A

prothrombin, thrombin

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2
Q

Extrinsic Pathway releases ________ which activates factors _____ and ______

A

Thromboplastin, VII. X

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3
Q

The clotting factor produced by the liver is ______?

A

fibrin

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4
Q

Fibrin binds with _____ which converts to _____ which will then break down ______ into degradation products.

A

plasminogen, plasmin, fibrin

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5
Q

Antiplatelet drugs will..?

A

inhibit platelet aggregation and prevent platelet plugs.

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6
Q

Thrombolytic drugs will?

A

lyse existing clots.

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7
Q

Antifibrinolytic drugs are also called ______ and will..?

A

hemostatic, promote blood coagulation.

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8
Q

Anticoagulants will inhibit the action or formation of c_____ f____ and will ultimately prevent _____ formation.

A

clotting factors, clot

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9
Q

Anticoagulants have no effect on _____ ______

A

present clots

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10
Q

Anticoagulants used prophylactically to prevent ____ formation and an ______

A

thrombus, embolus

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11
Q

Anticoagulants Indicated for these three scenarios

A
  1. A fib
  2. Indwelling devices, like mechanical heart valves.
  3. Major orthopedic surgery
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12
Q

Heparin is an ______ drug class and works by blocking the conversion of ______ to ______

A

anticoagulants, fibrinogen, fibrin.

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13
Q

heparin SQ has an onset of ____, and a duration of _____

A

20-60 minutes, 8-12 hours

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14
Q

Heparin IV has an onset of _____ and a duration of ______

A

5 minutes, 2-6 hours.

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15
Q

Heparin has laboratory monitoring every ____ hours and is ______ _______. The _____ test is used and should have a normal range of 20-40 seconds.
Therapeutic ranges are ____ to ____ times pre-treatment level.

A

6 hours, dose dependent, aPTT, 1.5-2.5 times.

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16
Q

Low-molecular weight heparins target more ____ clotting factors therefore= _n_____ m_______ is _n_____

A

specific, no monitoring is needed.

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17
Q

Enoxaparin (Lovenox) is which class of drug?
Which route do we give it?

A

LMWH or anticoagulant, SQ

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18
Q

What is the antidote of heparin?

A

Protamine sulfate

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19
Q

IV doses of Heparin should be ______
Preferrable spots for injection_____
list the places you absolutely shouldn’t inject within 2 inches of:
aspirating or massaging the area causes:

A

double checked with another nurse, only in deep SQ spots.
stoma, abdominal incisions, scars, drainage tubes, umbilicus, open wounds.
hematoma

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20
Q

_______ laboratory values are done daily to monitor coagulation effects of heparin.

A

aPTT

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21
Q

Avoid these foods _____, _____, ______, and ______ when taking warfarin.

A

green leafy vegetables, pork, fish, milk products

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22
Q

Which class of drug is warfarin?

A

anticoagulant

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23
Q

onset of warfarin is ______?

A

24-72 hours

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24
Q

PT range for warfarin?
INR therapeutic range?

A

9.5-12 seconds
2.0-3.5

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25
Q

For severe bleeding while on warfarin give transfusions of _____ ______ or c_____ f_____ c____s

A

human plasma, clotting factor concentrates.

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26
Q

Since the full therapeutic effect of _____ takes several days, we wait until PT and INR levels are adequate to stop giving _____ which was giving anticoagulant effects in place of ______.

A

warfarin, heparin, warfarin.

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27
Q

High doses of vitamin K (___mg) IV will reverse the effects of ______ within _____ hours.

A

10, warfarin, 6.

28
Q

When vitamin K is given while taking warfarin, there will be ______ resistance for up to ____ days.

A

warfarin, 7.

29
Q

These herbal products (7 items) increase the risk of bleeding with this medication:

A
  1. capsicum pepper
  2. ginger
  3. garlic
  4. gingko
  5. St. John’s wort
  6. Feverfew
  7. dong quai
    while taking with warfarin.
30
Q

Dabigatran (Pradaxa) is this class of drug____, and this category: ________.
you must have good ____ function.
the antidote is _____
The route is ___

A

anticoagulant, direct thrombin inhibitor, renal, Praxbind.
PO

31
Q

A direct thrombin inhibitor will inhibit _____ also called _____

A

IIa, fibrin.

32
Q

Fondaparinux (Arixtra) is this class of drug _____ and this category________.
A major side effect is _______.
Monitoring or not?
route?

A

anticoagulants, selective factor inhibitor, thrombocytopenia, no monitoring, and SQ.

33
Q

Selective factor inhibitors will inhibit ________

A

Xa

34
Q

Direct oral anticoagulants have action against factor ___ and the drugs are ______ and ______.
Both of their routes are _____
_____ has a counterindication for ______ ________.

A

Xa, Rivaroxaban (Xarelto), Apixaban (Eliquis), grapefruit juice

35
Q

Rivaroxaban has an antidote of _______ injection.

A

andexxa

36
Q

LMWHs are contraindicated in patients with an..? Due to risk of ________ _________

A

indwelling epidural catheter, epidural hematoma.

37
Q

Warfarin should never be taken in ______?

A

pregnancy

38
Q

Bleeding risks should be avoided with _______ and can happen with both _____ and _____.

A

warfarin, warfarin and heparin.

39
Q

Type 2 HIT is an acute fall in platelets of >___% and can lead to p_______ t__________
continued drug therapy can be _____.

A

50, paradoxical thrombosis, fatal.

40
Q

Warfarin can cause what two skin problems?

A

skin necrosis and “purple toes” syndrome.

41
Q

treatment of type 2 HIT?

A

thrombin inhibitors (lepirudin and argatroban)

42
Q

If any of these five symptoms occur while taking heparin then stop drug immediately.

A

hematuria, melena, petechiae, ecchymosis, gum or mucous membrane bleeding.

43
Q

___mg of protamine sulfate can reverse the effects of ____ units of heparin.

A

1, 100

44
Q

Antiplatelets work to prevent platelet _____ at the site of blood vessel injury.

A

adhesion

45
Q

High doses of aspirin can lead to…?

A

metabolic acidosis, respiratory alkalosis, tinnitus, and fluid and electrolyte imbalances.

46
Q

aspirin is contraindicated for ____ symptoms in children and teens because of this syndrome..?

A

flu, Reye’s

47
Q

Dipyridamole (Persantine) is an _________ drug and causes _____ changes. Often used with what drug?

A

antiplatelet, EKG, aspirin.

48
Q

Clopidogrel (Plavix) is what class of drug and what category?

A

antiplatelet, Adenosine diphosphate antagonist

49
Q

Eptifibatide (Integrilin) is what class of drug and what category?

A

antiplatelet, Glycoprotein IIb/IIIa receptor antagonist

50
Q

Which route of Eptifibatide is used? Where is it usually used at? What is it used for?

A

IV, ICU, cardiac catheterization.

51
Q

Thrombolytic drugs only work on ____-formed clots.

A

pre-formed

52
Q

older thrombolytic drugs are strepto_____ and uro_____

A

streptokinase, urokinase

53
Q

current thrombolytic drugs used?

A

t-plasminogen activators (tpa)

54
Q

Alteplase (Activase) is which class and category of drug?
the route is a ____ followed by a 90 min ____ infusion.

A

thrombolytic, tpa, bolus, IV

55
Q

Alteplase is indicated in _______ _____ _______.
Since this drug is weight based, give within ____ hours and for MI, only adults > ___ kg are qualified.
____ cost of drug.

A

acute ischemic stroke, 3, 67, high.

56
Q

Tenecteplase (TNKase) is what class and category of drug?
route?
indication? must start this drug within ____ hours of symptom onset.

A

thrombolytic, tPa, single IV bolus, MI, 6.

57
Q

thrombolytic drugs break down ____ into ____ which will dissolve the ____ network.

A

plasminogen, plasmin, fibrin.

58
Q

Thrombolytic drugs are indicated for a_____ t______, _____, o_____ of ____ or ______, and p_______ e_______

A

arterial thrombolysis, DVT, occlusion of shunts or catheters, pulmonary embolus.

59
Q

Three types of bleeding can happen with thrombolytic drugs. Name them.

A
  1. superficial
  2. intracranial
  3. internal
60
Q

three adverse effects of thrombolytic drugs?

A

n/v, cardiac dysrhythmias, hypotension.

61
Q

Name the two antifibrinolytic drugs?

A

tranexamic acid and desmopressin

62
Q

Antifibrionlytic drugs will _____ clot formation.

A

promote

63
Q

Antifibrinolytic drugs will prevent and treat excessive bleeding resulting from h________s or _______ complications.

A

hyperfibrinolysis, surgical.

64
Q

antifibrinolytic drugs are indicated in ________ and ____ _____ disease.

A

hemophilia, von Willebrand’s

65
Q

Desmopressin is a s______ p______e and indicated for which two conditions?
similar to which drug? which is an _____ hormone.
Nasal spray is used for n______ e_______s.

A

synthetic polypeptide, hemophilia, and diabetes insipidus, vasopressin, antidiuretic, nocturnal enuresis.

66
Q

Tranexamin acid the _________ drug class will form a _______ complex that displaces _______ from ________ resulting in inhibition of f________s

A

antifibrionlytic, reversible, plasminogen, fibrin, fibrionlysis.

67
Q

Tranexamic acid is indicated for what?
Can cause what with rapid IV injection.

A

used IV prior to surgery, hypotension.

Pharmacology (16 decks)

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