Drugs Flashcards
Heparin
Given IV or sub Q
Metabolized by the liver and renal eliminated
Based on weighT. Initial dose is 80 for the 18 unit bolus
IV heparin. It started every six hours after the start of treatment.
Pregnancy category see
Avoid in advance, hepatic, renal disease
Avoided bleeding disorder, active bleeding
Heparin uses
Prophylactically-those at risk for certain disorders to prevent DVT and pulmonary embolism
Major illnesses, such as a heart attack, heart failure, serious, pulmonary infection, stroke
Major, abdominal or thoracic surgery
A history of a clot, including pregnant women
Gynecologic surgery especially those taking estrogen
Restriction such as bedrest for limited activity, expected to last longer than five days
Low molecular weight heparin
Lovenox- given sub Q
Longer duration of anticoagulant affect alarm for once daily or twice daily
High degree of correlation between anti-x-ray and body weight, allowing for fix doses
Less intense nursing care in less than 10’s laboratory monitoring
More predictable, anticoagulant response permitting use now patient settings
Converting from heparin to warfarin
Heparin is usually given simultaneously with war friend in his bridge with war friend for a minimum of 4 to 5 days until the INR has been within 2 to 3 for two consecutive days
The bridge is required, because during the first few days of warfarin therapy, prolongation of INR mainly reflects depression of factor seven the intrinsic coagulation pathway that does not require a factor seven remains intact in this early.
Vitamin K antagonist
Warfarin Coumadin
Well, absorbed after oral
It acts on the liver to prevent synthesis of vitamin K dependent clotting factors 1 ,7, 9, 10
Effects not occur for 3 to 5 days
Long-term prevention of Venus thrombotic disorders
Precautions, pregnancy category, 10
Use cautiously and patience with fall risk dementia, uncontrolled hypertension
Avoided hypermetabolic state
Warfarin Coumadin adverse drug reactions
Bleeding, especially in older adults
Antidote is vitamin K
Mini drug to drug interactions
Anticoagulant affect may be decreased by oral contraceptives, carbamazepine and vitamin K containing food. Leafy greens.
Start at 5 mg per day 7.5 mg of weed greater than 80.
Consider a low-dose, if
Older than 75 multiple comorbid conditions, elevated liver enzymes, changing thyroid status
Warfarin Coumadin monitoring
INR to be between two and three
INR daily until therapeutic range for two consecutive days
Then two or three times weekly for one or two weeks
Then less frequently, but at least every six weeks
INR should be between two and three for treatment of a clot, stroke prevention, and Ethan DVT/PE
INR should be between 2.5 and 3.5 for heart valves prior history of thrombus events in INR 2 to 3.
Questions to ask when INR results are unexpected
Have you missed any doses?
Have you taken any extra doses?
Are you taking the meds we should
Are you having breathing problems?
Are you having blood clot complications?
Have you started any new meds or changed?
Is your underlying condition changed so she’s gotten worse
Cause your thyroid changed
Has a malignancy been diagnosed
Guidelines for reversing warfarin
The reason for bleeding should be evaluated. Consider holding want to doses stop other meds that cause bleeding first consider restarting the lower dose in monitor INR more frequently.
INR 4.5 to 10 and no evidence of bleeding.
No administration of vitamin K or consider giving 1.25 mg to 2.5 mg of oral vitamin K depending on cause of elevated INR consider resuming therapy at a lower dose.
I had a greater than 10 with no evidence of Bleeding
Give one dose of oral vitamin K, 2.5 mg. The eye and I will fall in 24 to 48 hours required. Our trucks are necessary an additional doses of aura vitamin K can be given if INR is still elevated. Once I in our falls in target range orphan could be resume to deliver those.
Guidelines for reversing, Coumadin with bleeding
Significant bleeding. Patients who are bleeding regardless of what INR is need immediate reversal of the INR and should have their Coumadin temporary discontinued. 4f-pccs IV vitamin K5 to 10 mg should be given
Depending on what INR is repeat, this is a vitamin K can be given every 12 hours
Xarelto or Eliquis Pradaxa facts
prevents conversion of fibrinogen to fibrin
Advantage over warfarin faster, onset of action 2 to 4 hours
No bridging between injectable
Fix dosing your dietary precautions
If your dog dog interactions
There is no specific antidote summer twice daily dosing
Antiplatelet drugs aspirin pharmokinetics
Aspirin
Inhibits Cyclooxygenase
Interferes with platelet aggregation
Well, absorbing taken orally
Metabolized in the liver
Renally excreted
Aspirins precautions
Hypersensitivity cross sensitivity with NSAIDS
Pregnancy category C D, and third trainmaster
Reye syndrome and kids
May cause G.I. bleeding
Tinnitus
Must be stop seven days before surgery
Antiplatelet drug Plavix
Reduces platelet aggregation by inhibiting adenosine, diphosphate pathway ADP

Plavix, PharmaKinetics
Prodrug metabolized to active metabolite
Excreted in urine and feces M
Precautions and contraindications, active major bleeding
Side effects, diarrhea rash
Clinical uses of aspirin and dosage
Myocardial infarction prevention-75 to 162 mg daily
Persistent a fib -75 to 325 mg daily
Stroke or TIA - 50 to 100 mg daily
Clinical uses of Plavix clopidogrel
MI prevention-75 mg daily
ST elevation, acute coronary syndrome, 300 mg daily, if less than 75 years of age and 75 mg daily of more than 75 years of age
