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Olsen Pharm exam 3 > Drugs Affecting blood coagulation > Flashcards

Drugs Affecting blood coagulation Flashcards

1
Q

Oral Antiplatelet agents

A

Anagrelide (Agrylin)
ASA
clopidogrel (Plavix)

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2
Q

IV Antiplatelet agents

A

abciximab (Reopro)
eptifidatide (Integrillin)
tirofiban (Aggrastat)

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3
Q

oral antiplatelet prototype

A

ASA

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4
Q

Actions of ASA

A

Inhibits platelet aggregation by inhibiting platelet synthesis of thromboxane A2.

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5
Q

Indications for ASA

A

reduction of risk of recurrent TIAs or stroke w/ a history of TIA d/t fibrin or platelet emboli; s/p MI and in pts w/ unstable angina. MI prophylaxis also used for anit-inflammatrory, analgesiic, and antipyretic effects.

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6
Q

Pharmo of ASA

A 
Route- oral
Onset- 5-30 min
Peak - 0.25-2 h
Dx- 3-6 h
T 1/2- 15 min to 12 h; metabolized in liver and excreted in urine.
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7
Q

Adverse effects for ASA

A

acute ASA toxicity w/ hyperpnea, possibly leading to fever, coma, and cardiovascular collapse; N, dyspepsia, heartburn, epigastric discomfort, GI bleeding, occult blood loss, dizziness, tinnitus, difficulty hearing, anaphylactiod rxn.

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8
Q

Caution for ASA

A

bleeding disorder,recent surgery, closed- head injury.

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9
Q

Special info oral antiplatets.

A

Eat small meals to buffer. est baseline CBC and clotting studies. Monitor platelet count if indicated. safety measures to decrease risk of bleeding. Increase bleeding precautions during invasive procedures. provide pt teaching- medical alert device.

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10
Q

Anticoagulants

A

warfarin (Coumadin)- oral onset of action is 3 days

heparin - IV or SubQ onset is immediate.

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11
Q

D2D interaction with anticoagulants

A

Warfarin- interacts w/ many drugs. Monitor pts when drug regimen is change. Pts should maintain consistent intake of Vit K food.
Heparin- decreased anticogaulation when pts taking NTG.

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12
Q

actions of heparin

A

inhibits thrombus and clot production by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin.

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13
Q

Indications for heparin

A

prevention and treatment of venous thrombosis and pulmonary emboli; treatment of Afib w/ embolization; dx and treatment of DIC; prevention of clotting in blood samples and heparin locksets.

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14
Q

parmo for heparin

A 
Route- IV and SQ
Onset- immediate, 20-60 min
Peak- min, 2-4 h
Dx- 2-6h, 8-12 h
T 1/2 30 to 180 min; metabolized in cells and excreted in urine.
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15
Q

Adverse effects of heparin

A

loss of hair, bruising, chills, fever, osteoporsis, suppression of renal function,

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16
Q

Thrombolytic agents

A

urokinase (abbokinase)
streptokinase (streptase)
alteplase (activase)

17
Q

contraindications for thrombolytic agents

A

any condition that will be worsened by the dissolution of clots.

18
Q

Actions for urokinase

A

converts endogenous plasminogen to plasmin, which breaks down fibrin clots, fibrinogen and other plasma proteins, lyses thrombi and emboli.

19
Q

Indications for urokinase

A

lysis of pulmonary emboli or pulmonary emboli w/ unstable hemodynamics in adults.

20
Q

Pharmo for urokinase

A 
Route- IV
Onset- immediate
Peak- end of injection
Dx- NA
T 1/2 unknown, metabolized in plasma; excretion method unk.
21
Q

Adverse effects for urokinase

A

HA, anigoneurotic edema, hypotension, skin rash, bleeding, breathing difficulties, bronchospasm, pain, fever, anaphylatic shock.

22
Q

Nursing considerations for thrombolytic agents

A

d/c heparin before administering thrombolytic, bleeding precautions, monitor coagulation studies, assess for blood loss, monitor cardiac rhythm if given for MI,

23
Q

Low weight molecular heparin

A

enoxaparin (Lovenox)

24
Q

Special info on Lovenox

A

does not affect thrombin, clotting, or PT. Block angiogensis, the process that allows cancer cells to develop new blood vessels, used to prevent clot formation s/p surgery or prolonged bed rest- all orho pts. need to rotate the site on the ABD. Leave air bubble in the drug. AE= fever, nausea.

25
Q

Antihemophilic Agents

A

antihemophilic factor (Bioclate)

26
Q

Actions for antihemophilic factor

A

normal plasma protein that is needed for the transformation of prothrombin to thrombin, the final step in the clotting pathway.

27
Q

Indications for antihemophilic factor

A

treat of classic hempophilia to provide temporary replacement of clotting factors to correct or prevent bleeding episodes or to allow necessary surgery.

28
Q

pharmo for antihemophilic factor

A 
Route- IV
Onset- immediate
Peak- unk
dx- unk
T 1/2- 12hr; cleared by normal protein metabolism.
29
Q

Adverse effects for antihemophilic factor

A

Allergic rxn, sting at injection site, HA, rash, chills Nausea, hepatitis, AIDS.

30
Q

nursing considerations for antihemphilic factor

A

monitor clotting factor levels, type and cross match blood, safety.

31
Q

Hemostatic agents

A

aminocaproic acid (Amicar)

32
Q

Actions of aminocaproic Acid

A

inhibits plasminogen activator substance and has antiplasmin activity that inhibits fribrinolysis and prevents the breakdown of clots.

33
Q

Indication for amiocaproic acid

A

treat excessive bleeding resulting from hyperfribrinolysis; prevent recurrence of subarachnoid hemorrhage, for management of megakaryocytic thrombocytopenia, to decrease the need for platelet administration, and to abort and treat attacks of hereditary angioneurotic edema.

34
Q

Pharmo for aminocapric acid

A 
route- oral, IV (systemic) topical is used when surface damage involves so many vessels that clotting can't occur. 
onset- rapid, immediate
peak- 2 h, minutes
dx- unk, 2-3 h
T1/2- 2 hr, excreted unchanged in urine.
35
Q

Adverse effects for aminocapric acid

A

dizziness, tinnitus, HA, weakness, Hypotension, Nausea, cramps, diarrhea, fertility problems, malaise, elevated serum CPK.
Systemic- too much clotting, psychotic states
Topical- risk for infection.

36
Q

D2D for amiocapric acid

A

systemic- oral contraceptives or estrogen

topical- none

Olsen Pharm exam 3 (5 decks)

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