Coagulation Modifiers

Question 1

List of modifiers

Answer 1

*For preventions of clots:

Anticoagulants -

Antiplatelets - prevent platelets from clumping together

*For Cath lab and in ICU

Thyrombolytics - work to break up clots

Antifibrolytics - work to keep body from breaking down existing clots

Question 2

Anticoagulant - Warfarin

Answer 2

give Vit K if overdose

PO - for CHRONIC management

watch INR to see level; 2-3.5 is therapeutic level

Drug interactions with NSAIDs and amiodarone

Question 3

Anticoagulant - Heparin

Answer 3

give protamine sulfate for overdose

IV - for ACUTE situations (like Active MI or pulmonary embolism)

watch aPTT to monitor heparin; 2 is normal therapeutic level

Question 4

Anticoagulant - Enoxaparin

Answer 4

No AEs

low molecular weight; given as prophylaxis

Question 5

Anticoagulant - general info

Answer 5

MOA - bind to different substances in clotting cascade to prevent clot formation

Indication - any situation where clothing is undesirable such as CAD/MI, Stroke, DVT, Afib

Contraindications - allergy, thrombocytopenia, pregnancy (Warfarin), epidural (lovenox)

AEs (for War and Hep) - bleeding, bruising, hematuria

Interactions - be careful when giving two anticoagulants/antiplatelets together, amioderone, HMG-CoA (all additive); Barbiturates and rifampin cause decreased effects of anticoagulants

Question 6

Antiplatelets - Aspirin

Answer 6

MOA - inhibits cyclooxygenase - prevents platelets from aggregating to narrowed blood vessel walls

AEs - drowsiness, confusion, GI bleed, coagulopathy

Question 7

Antiplatelets - Clopidogrel

Answer 7

MOA - alters platelet membrane and platelet cannot receive signal to aggregate

AEs - chest pain, HA, rash, itching, abdominal pain

Question 8

Antiplatelets - general info

Answer 8

Indications - stroke prevention, post-MI thrombosis, clotting disorders, adjunct therapy to anticoagulants

Contraindications - allergy, coagulopathies, active bleeds, traumatic injuries, vitamin K deficiencies