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Pharm Chapter Exam 2 materials > Coagulations > Flashcards

Coagulations Flashcards

1
Q

What are anticoagulants used for?

A

Used in thrombotic disorders to prevent New clot formation.

Think of DVT, PE, Thrombophlebitis or Post-op Surgery

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2
Q

What are antiplatelets used for?

A

To prevent arterial thrombosis by suppressing platelet aggregation

For patients with Hxn of bypass surgery, MI, and Stents

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3
Q

What are Thrombolytics used for?

A

Dissolve thrombi and limit tissue damage in thromboembolic disorders.

For strokes.

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4
Q

What is the adverse effect of anticoagulants?

A

Bleeding.

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5
Q

What are things Anticoagulants not used for?

A

It is not used for dissolving formed clots.

Does not improve blood flow in tissues around the clot.

Does not prevent ischemic damage beyond the clot.

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6
Q

What drug is classified as an anticoagulant?

A

Heparin.

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7
Q

What is the MOA of Heparin?

A

Depends on Dosage.

Low dosage = Inactivates factor Xa and inhibits conversion of prothrombin to thrombin.

High dosage = inactivates factors Ix, X, XI, XII and thrombin and inhibits conversion of fibrinogen to fibrin.

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8
Q

What is Heparin used for?

A

DVT and PE prophylaxis and treatment

Acute coronary syndromes: PCI, STEMI

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9
Q

What are ASE of Heparin?

A

HIT (Heparin induced thrombocytopenia), ecchymosis, bleeding risk, hypersensitivity, N/V

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10
Q

How is Heparin administered?

A

IV or SQ

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11
Q

What lab value should be monitored for Heparin?

A

PTT. Therapeutic range is 45-70

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12
Q

What is the contraindication for Heparin?

A

Severe thrombocytopenia.

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13
Q

What should be taught to patients with Heparin?

A

Rotate injection sites, teach bleeding risk precautions, hold pressure to wounds, report severe symptoms.

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14
Q

What drug is classified as Low Molecular Weight Heparins (LMWH)?

A

Enoxaparin.

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15
Q

What is the MOA of Enoxaparin?

A

Inactivates coagulation factor Xa and produces anticoagulation.

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16
Q

What is Enoxaparin used for?

A

DVT prophylaxis, ACS, unstable angina, acute DVT

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17
Q

What are the ASE of Enoxaparin?

A

Injection site hematoma, nausea, peripheral edema, bleeding

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18
Q

What is the antidote of Enoxaparin?

A

Protamine sulfate

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19
Q

What administration safety should the nurse know about Enoxaparin?

A

Air bubble is needed

DO NOT RUB SITE AFTER INJECTION

Peaks 3-5 hours and lasts 12 hours SQ

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20
Q

Do we need PTT monitoring for Enoxaparin?

A

No

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21
Q

What can be caused by Heparin Induced Thrombocytopenia?

A

Thrombocytopenia and Thrombosis due to peripheral platelet consumption and platelet activation.

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22
Q

What should the nurse do if the patient is suspected of HIT?

A

DISCONTINUE THE DRUG IMMEDIATELY.

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23
Q

What is a normal platelet count?

A

150000 to 3500000

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24
Q

What medication can be used for HIT instead of heparin?

A

Direct thrombin inhibitors

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25
How would platelet count look like for patient with HIT?
Their platelet count would decrease by 30-50% of the their baseline (pre-heparin) platelet count.
26
Can HIT occur with LMWH?
Yes, but less common.
27
Is HIT life-threatening?
Yes
28
What drug is classified as an Anticoagulant?
Warfarin.
29
What is the MOA of Warfarin?
Interferes with hepatic synthesis of Vitamin K-dependent clotting factors. Prevents formation of blood clots.
30
What is Warfarin used for?
Prevention of venous thromboembolism, Atrial fibrillation embolization, coronary thrombosis, pulmonary embolism.
31
What are the ASE of Warfarin?
Bleeding, anemia, hemorrhage, fever, dizziness, lethargy, fetal malformations, and abnormal bone development.
32
How is Warfarin administered?
PO or IV
33
What are the contraindications of Warfarin?
Pregnancy, bleeding, or hemorrhagic tendencies
34
What is the antidote of Warfarin?
Vitamin K
35
What should the nurse be aware of with Warfarin?
It is a highly protein bound medications so use precaution when giving with another highly protein bound medication due to increased risk of warfarin toxicity
36
What should the nurse monitor for with a patient on Warfarin?
PT/INR. Target is 2-3
37
A patient on warfarin asked if he has to stop eating spinach when on warfarin. What should the nurse say?
Do not avoid foods with Vitamin K. Just have a consistent amount of Vitamin K food everyday.
38
What class is Apixaban under as?
Anticoagulant.
39
What is the MOA of Apixaban?
Factor Xa inhibitor
40
What is Apixaban used for?
Nonvalvular A-Fib, DVT, PE, Venous Thromboembolism prophylaxis
41
What are the ASE of Apixaban?
Hemorrhage, thrombosis with premature discontinuation.
42
What are the contraindications for Apixaban?
Hypersensitivity and active bleeding.
43
What is the antidote for Apixaban?
Andexanet alfa.
44
What needs to be monitored for patients on Apixaban?
Nothing. No monitoring is needed.
45
What drug is classified as Direct Thrombin Inhibitors (DTI)?
argatroban
46
What is the MOA of argatroban?
Directly inhibits thrombin from converting fibrinogen to fibrin.
47
What is argatroban used for?
HIT, DVT, PE, Percutaneous Coronary Intervention
48
How is argatroban administered?
IV only
49
What are the ASE of argatroban?
Bleeding, hypotension, chest pain, cardiac arrest, injection site reaction, N/V, GI upset, anemia, hematoma
50
What is the antidote for argatroban ?
None
51
What are antiplatelets mainly used for?
Prophylatic use. AKA prevent MI and strokes
52
A patient that uses daily low dosage aspirin is scheduled for a surgery. What should the nurse do?
Tell the patient to stop taking their antiplatelet medication for 7 days before their surgery.
53
What drug is classified as an Antiplatelet agent?
Clopidogrel
54
What is the MOA of Clopidogrel?
Inhibits platelet aggregation and prevents ADP from binding to ADP platelet receptors
55
What is Clopidogrel used for?
To prevent thrombosis associated with unstable angina, acute MI, stroke, TIA
56
What ASE is associated with Clopidogrel?
Hypotension, hypertension, bronchospasm, elevated hepatic enzymes, peptic ulcer
57
How is Clopidogrel administered?
PO
58
What should be taught to a patient on Clopidogrel?
Increased bleeding risk when taken with certain herbal supplements like ginger, garlic, and green tea. Do not take grapefruit juice Higher risk for bleeding and bruising.
59
When should labs be drawn for Heparin?
1 hour prior to dosing
60
When should labs be drawn for Warfarin>
Daily until therapeutic. Then drawn every 2 to 4 weeks for duration of anticoagulant therapy.
61
What is the main goal of using thrombolytic agents?
To reestablish blood flow as quickly as possible. Prevent/limit tissue damage.
62
What drug is classified as Thrombolytic?
alteplase (Activase)
63
What is the MOA of alteplase?
To convert plasminogen to plasmin, which digests fibrin and dissolves clot; also initiates fibrinolysis.
64
What is alteplase used for?
To dissolve existing clots, treat acute MI, DVT, CVA, PE, arterial thrombosis, to clear IV catheters.
65
What ASE are associated with alteplase?
Abnormal bleeding, Stroke, dysrhythmias, PE
66
What is contraindicated with alteplase?
Patients with bleeding disorder or who have had recent trauma or surgery.
67
How is alteplase administered?
Must be given within 12 hours of symptoms of MI and 3 hours of CVA.
68
What is the antidote of alteplase?
Aminocaproic acid
69
What are the contraindications for Thrombolytic Therapy?
Uncontrolled severe HTN Aneurysm AV malformation Internal bleeding Intracranial or intraspinal surgery.
70
What labs are usually needed prior to Thrombolytic therapy?
INR, aPTT, platelet count

Pharm Chapter Exam 2 materials (6 decks)

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