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drug therapy coagulation disorders Flashcards

(73 cards)

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1
Q

heme means

A

blood

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2
Q

stasis means

A

halt

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3
Q

hemostasis means

A

halt of the blood

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4
Q

inferior vena cava brings blood from

A

the lower body extremities

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5
Q

prevention in hemostasis is what

A

stoppage of blood loss from injured vessel (maintains vascular compartment integrity)

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6
Q

mechanisms involved in hemostasis

A

vasoconstriction

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7
Q

what will you see with hemostasis

A

formation of platelet plug, sequential activation of clotting factors, reparation of the opening in damaged vessel

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8
Q

plasminogen & fibrin form color = what

A

stops blood flow = blood vessel repaired = plasmin(fibrinolysis) dissolves clot

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9
Q

what is the primary organ responsible for clotting factors

A

liver

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10
Q

intrinsic pathway is activated where

A

by trauma inside the blood vessels, starts when blood is exposed to collagen factor 12

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11
Q

extrinsic pathway occurs when

A

there is external trauma that occurs (vascular tissue trauma or trauma around the tissue)

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12
Q

thrombogenesis

A

formation and dissolving of thrombi; normal body defense

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13
Q

atrial thrombosis

A

obstruct arterial blood flow

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14
Q

what causes arterial thrombosis

A

atherosclerosis, HTN, turbulent arterial blood flow

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15
Q

incomplete blockage of arterial thrombosis

A

deficient blood flow= ischemia

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16
Q

complete blockage of arterial thrombosis

A

obstruction = necrosis (tissue death)

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17
Q

when there is damaged arterial endothelium what happens

A

platelet activation

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18
Q

venous thrombosis

A

result of venous stasis

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19
Q

slow venous blood flow =

A

thrombin and procoagulant substances become concentrated and form embolus

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20
Q

venous thrombosis is what compared to arterial thrombus

A

it is less cohesive making easily detachable and travel

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21
Q

pulmonary embolism are

A

life threatening

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22
Q

classic deep vein thrombosis s/sx

A

pain in lower extremities, erythema, swollen, hot (heat),

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23
Q

with atherosclerosis, you will see

A

elevated lipid serum levels, lipid filled macrohphages = fibrous plaques/ lesions = severe ulceration and scar tissue

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24
Q

if the blood clot in in the heart what could happed

A

myocardial infarction

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25
if blood clot is in the brain, what could happen
TIA(warning sign to a stroke)/ CVA/ stroke
26
anticoagulants are used for
thrombotic disorders (more effective in preventing venous thrombus)
27
antiplatelets are used to
prevent arterial thrombosis
28
thrombolytics do what
dissolve thrombi and limit tissue damage in thromboembolic disorders
29
(venous) anticoagulants do not
dissolve clots
30
anticoagulants prevent
newer formation or management of thromboembolic disorders, thrombophlebitis, DVT, pulmonary embolism
31
adverse effects of anticoagulants
bleeding
32
anticoagulant medications
heparin(does not dissolve existing clot), warfarin, fondaparinux, dabigatran, rivaroxaban, apizaban
33
heparin is given to
prevent new clot formation and extension of clots present; prevention and management of thromboembolic disorders (Afib, DVT, PE)
34
if giving heparin IV what do you monitor
aPTT/PTT per heparin nanogram protocol: lab drawn ~equal to 1 hour before dosing until therapeutic/ bridge to oral anticoagulation
35
if giving heparin SQ it is for
DVT formation prevention in bed restricted hospital patients
36
SQ of heparin medication
enoxaparin: low molecular weight heparin (prefilled syringe with air lock)
37
antidote for heparin
protamine sulfate (base)
38
antidote for warfarin
vitamin K
39
when teaching patients about warfarin what do you want to teach
avoid foods high in vitamin K: green leafy veggies, green tea; avoid grapefruit juice, cranberry juice and alcohol
40
what to monitor with warfarin
PT/IRN (should be between 2-3)
41
standard dose of heparin
25,000 units in 500 mL D5W IV start at 1000 units/hr
42
fondaparinux (arixtra) is
factor Xa inhibitor, SQ injection only (prevention of DVT post hip/knee surgery), can be IV in pt's with heparin induced thrombocytopenia
43
dabigatran (Pradaxa) is
direct thrombin inhibitor, Tx of Afib/ stroke prevention/ PO twice a day; idarucizumab = antidote
44
dabigatran (Pradaxa) is
direct thrombin inhibitor, Tx of Afib/ stroke prevention/ PO twice a day; idarucizumab = antidote
45
rivaroaxaban (Xarelto) is
factor Xa inhibitor; Tx of Afib/ stroke prevention/ secondary DVT prevention/ PO once a day
46
apixaban (eliquis) is
factor Xa inhibitor' Tx of Afib/ stroke prevention/ PO twice daily
47
s/sx of using anticoagulants
ecchymosis(increase bruising), prolongation of bleeding episodes, dizziness, lightheaded, hypotension, low hbg/hct, bloody/dark urine, CP/SOB/ hemoptysis(cough up blood)
48
what issues may patients experience with anticoagulants
gastrointestinal issues (dyspepsia, nausea, upper abdominal pain, GI hemorrhage and diarrhea)
49
the use of what is discouraged when taking anticoagulants
NSAID (increased rheumatoid factor GI ulcers/ bleeding)(ibuprofen, alive, aspirin)
50
antiplatelets act by a variety of mechanisms such as
inhibit platelet activation, inhibit platelet adhesion, inhibit platelet aggregation, inhibit procoagulant activity
51
adverse effects of antiplatelets
depend on medication; increase risk fro bleeding
52
anti platelet medications
clopidogrel, aspirin, abciximab, cilostazol, anagrelide
53
clopidogrel (plavix) is what
ADP receptor antagonist; irreversibly inhibit ADP receptor on surface of platelets (no antidote); extensive first pass= slow loading dose required; can be used in conjunction with ASA
54
common side effects of clopidogrel
pruritus, rash, purpura, and diarrhea
55
a patient on clopidogrel, do not use in patient with
bleeding or peptic ulcer disease
56
aspirin is what
thromboxane A2 inhibitors; inhibits synthesis of prostaglandins = prevents formation of thromboxane A2 = prevents PLT aggregation and thrombus formation
57
when to give aspirin
for long term prevention of MI, CVA and for patients with prosthetic heart valves/ hx of stents that require antiplatelet need/ also give or suspicion of active MI or TIA
58
side effects of aspirin
minimal at low dose/ can have rheumatoid factor bleeding/ stomach ulcers
59
abciximab is what
glycoprotein IIb/IIIa receptor antagonists; monoclonal antibodies that prevent the binding of fibrinogen, this action will inhibit platelet aggregation
60
abciximab is used for interventional procedures with
ASA and heparin (side effects: insertional site bleeding = pressure)
61
cilostazol is what
phosphodiesterase- 3 enzyme inhibitors: inhibits platelet aggregation and produces vasodilation
62
cilostazol is used for
management of intermittent claudication
63
claudication is a symptom of
the peripheral artery or peripheral vascular disease
64
anagrelide does what
inhibit platelet aggregation induced by cAMP phosphodiesterase, ADP, and collagen
65
anagrelide is used for
to reduce platelet counts r/t essential thrombocythemia (excessive numbers of platelet)
66
thrombolytic agents do what
given to dissolve thrombi; stimulate conversion of plasminogen to plasmin (enzyme that breaks down fibrin); management of acute, severe thromboembolic disease (MI, PE, thrombi-emolic stroke)
67
goal of thrombolytic agents
reestablish blood flow as quickly as possible, prevent/ limit tissue damage
68
adverse effect of thrombolytic agents
bleeding
69
thrombolytic therapy high risk medication
altepase; recombinant plasminogen activator: protein that will lysis or destroy clots
70
altepase tx
thrombus dissolution post CVA/ massive PE to restore pulmonary perfusion
71
altepase is administered by
IV, metabolized in live, excreted by the kidneys; 50% of medication is cleared from body in 10 minutes
72
side effects of altepase
systemic bleeding, HA, epistaxis(bleeding from nose), hemoptysis, GI bleed
73
contraindications of altepase
allergy, intracranial surgery/ spinal surgery, severe hypotension, active bleeding/ coagulation issues/ anticoagulation med, recent surgery, stroke aneurysm in last 2 months

pharm exam 2 (8 decks)

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