CoagulationModifier Agents Flashcards
Anticoagulant?
Heparin
LWMH (levonox, Fragmim)
What are the 4 categories of Coagulation Modifier agent?
Anticoagulant
Anti platelet
Thrombolytic agents
Hemorrherologic agents
Contraindications for Lwmh?
Stoke
Peptic Ulcer
Blood Abnormalies
Eye brain or spinal injury.
Anti platelets
- Aspirin
- Dipyridamole (persantine)
- Adenosine phosphate receptor blocker (plavix, ticlopidine)
- glycoprotein IIa/IIIb: abciximab (reopo)
Thrombolitics
Streptokinase
Urokinase
Altepase (TPA)
Anti platelet contraindications
Active bleeding
Neutropenia
Thrombocytopenia
Severe liver disease
Contraindications for Thrombolitics
Hx of CVA within the last 2 months Intracranial or spinal injury Intracranial tumor or recent injury Severe HTN Gi bleed
What labs should be monitor for Heparin
PTT, aPTT, and platelets
Labs to monitor for Coumadin
PT and INR
Labs to monitor for Fragmin
PTT and platelets
Heparin black box warming
Epidural and spinal hematoma may result in paralysis.
Labs to monitor with trental (Hemorrherologic )
aPTT, PT, PTT, Hct and Hgb.
Labs to monitor in particular with streptokinase
ECG
What are sources of dietary vit K
Cabbage, cauliflower, spinach, green leafy vegetable
Oral coagulant mechanism of action
Inhibit hepatic synthesis of vitamin K
- warfarin
- Dicumarol
What is the INR desired value when pt is on oral anticoagulant Coumadin?
2-3 INR
3 =bleeding tendency
Antidote to Coumadin
Vitamin K
Antiplatelet mechanism of action
Prevent thrombosis by suppressing platelet aggregation
More effective with arterial thrombosis
Clopidrogel (plavix) route and dosage
PO 75mg/day
Apspirine route and dosage
PO, 80- 325mg/ day
Alteplase (TPa) maximum dose and normal administration
Max is 100mg
Administered as IV bolus in 3 different dose and time
1st bolus then 30 min infusion and then 60 min infusion
