Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm 140 > drugs affecting coagulation > Flashcards

drugs affecting coagulation Flashcards

1
Q

extrinsic pathway

A

cascade of clotting factors in blood that has escaped the vascular system to form a clot on the outside of the vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

hemostatic agents

A

drugs that stop blood loss usually by blocking the plasminogen mechanism and preventing blood clot dissolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

intrinsic pathway

A

cascade of clotting factors leading to the formation of a clot within an injured vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

plasminogen

A

natural clot dissolving system; converted to plasmin (fibrinolysin) by many substances to dissolve clots that have formed and to maintain the patency of injured vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

thrombolytic agents

A

drugs that lyse, or break down, a clot that has formed; these drugs activate the plasminogen mechanism to dissolve fibrin threads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

clotting factors

A

substances formed in the liver that react in a cascading manner to cause the formation of thrombin from prothrombin; thrombin breaks down fibrin threads from fibrinogen to form a clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

antiplatelet agents

A

decrease the formation of the platelet plug by decreasing the responsiveness of the platelets to stimuli that would cause them to stick and aggregate on a vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

aspirin

A 
antiplatelet medication (book prototype)
indications: reduction of r/o TIA, reduction of death or nonfatal MI in pts with hx of infarction or unstable angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

aspirin pharmacokinetics

A

PO: onset 5-30 min

peak 0.25 - 2h

duration: 3 - 6 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

aspirin side effects

A

black box warning for fatal bleeding events

headache
dizziness
weakness
nausea/GI upset
skin rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

arterial thrombosis

A

most common cause of MI, stroke, and gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

venous thrombosis

A

leads to pulmonary embolism and postphlebitic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clopidogrel (Plavix)

A

antiplatelet drug (powerpoint prototype)

used to reduce atherosclerotic events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clopidogrel (Plavix) pharmacokinetics

A

administered PO, metabolized in liver. protein bound,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clopidogrel (Plavix) pharmacodynamics

A

inhibits binding of ADP to its platelet reception and subsequent ADP mediated activation of glycoprotein complex to inhibit platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

clopidogrel (Plavix) contraindications

A

hypersensitivity, active bleeding disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clopidogrel (Plavix) adverse effects

A

bleeding, GI distress, neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

clopidogrel (Plavix) interactions

A

tamoxifen, tolbutamide, warfarin, torsemide, fluvastatin, many NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

clopidogrel (Plavix) nursing diagnoses

A

risk for injury: increased risk for bleeding r/t decreased platelet aggregation

risk for nause: r/t adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

clopidogrel (Plavix) planning/interventions

A

max therapeutic effects: ensure it is taken routinely

min adverse effects: take with food to reduce GI distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

alteplase recombinant (Activase)

A

thrombolytic drug (powerpoint prototype)

may be given systemically or at the site of the clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

alteplase recombinant (Activase) indications

A

acute MI
PE
acute ischemic stroke
thromboembolic conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

alteplase recombinant (Activase) pharmacokinetics

A

given IV; rapidly cleared from plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

alteplase recombinant (Activase) pharmacodynamics

A

converts plasminogen to plasmin

acts in same way as endogenous tPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
alteplase recombinant (Activase) contraindications
hypersensitivity, active internal bleeding
26
alteplase recombinant (Activase) adverse effects
internal or superficial bleeding
27
alteplase recombinant (Activase) interactions
other anticoagulant and antiplatelet drugs
28
alteplase recombinant (Activase) nursing diagnosis
risk for injury: r/t drug induced bleeding
29
alteplase recombinant (Activase) planning/intervention
max therapeutic effect: reconstitute in sterile water for injection without preservatives min adverse effect: closely monitor for signs of active bleeding, ensure pt connected to cardiac monitor
30
antihemophilic factor
clotting factor (powerpoint prototype) replaces normal blood clotting factor in event of deficiency
31
antihemophilic factor indications
deficiency of clotting factor VIII | hemophilia A
32
antihemophilic factor pharmacokinetics
given IV | T 1/2: 4-24 hrs
33
antihemophilic factor pharmacodynamics
Factor VIII is an essential component of blood clotting and is required for conversion of prothrombin to thrombin
34
antihemophilic factor contraindications
hypersensitivity to mouse protein
35
antihemophilic factor adverse effects
anaphylaxis urticaria nausea chills
36
antihemophilic factor nursing diagnosis
risk for injury: hemorrhage r/t deficiency of clotting factor VIII
37
antihemophilic factor planning/interventions
max therapeutic effect: refrigerate AHF until used, warm before reconstitution min adverse effect: administer AHF within 3 hrs of dilution, administer IV only
38
aminocaproic acid (Amicar)
hemostatic drug (powerpoint prototype) stops blood loss by enhancing coagulation
39
aminocaproic acid (Amicar) indications
life threatening hemorrhage
40
aminocaproic acid (Amicar) pharmacokinetics
given PO or IV | excreted mostly unchanged in urine
41
aminocaproic acid (Amicar) pharmacodynamics
blocks action of plasminogen activators | interferes with binding of active plasmin to fibrin
42
aminocaproic acid (Amicar) contraindcations
active intravascular clotting disorders
43
aminocaproic acid (Amicar) adverse effects
GI distress (n/v/d), headache, dizziness, seizures, hypotension, arrhythmias, tinnitus, nasal congetsion, abdominal cramps, diuresis
44
aminocaproic acid (Amicar) interactions
oral contraceptives or estrogen
45
aminocaproic acid (Amicar) nursing diagnosis
risk of altered cardiovascular perfusion: r/t volume loss 2/2 uncontrolled bleeding or thrombophlebitis
46
aminocaproic acid (Amicar) nursing intervention
min adverse effects: monitor vitals prior to and during therapy administer via IV infusion pump monitor I&O and neurologic status
47
aminocaproic acid (Amicar) pt education
change position slowly
48
parenteral anticoagulants
prevent the conversion of fibrinogen to fibrin
49
oral anticoagulants
prevent synthesis of factors dependent on vitamin K
50
heparin pharmacotherapeutics
prototype parenteral anticoagulant that interferes with final steps of clotting cascade safe for pregnant women occurs naturally in body
51
heparin pharmacokinetics
given IV or subQ | metabolized in liver, excreted in urine
52
heparin pharmacodynamics
rapidly promotes the inactivation of factor X, which in turn, prevents conversion of prothrombin to thrombin
53
heparin contraindications
hypersensitivity
54
heparin adverse effects
bleeding, thrombocytopenia
55
heparin nursing diagnosis
risk for injury: hemorrhage r/t drug therapy thrombocytopenia 2/2 drug therapy
56
heparin planning/intervention
max therapeutic effect: monitor lab values, allow heparin to reach steady levels before PTT is measured min adverse effect: decrease dosage if PTT exceeds desired range
57
heparin antidote
protamine sulfate
58
warfarin
oral anticoagulant used prophylactically for pts with long term r/o thrombus formation
59
warfarin pharmacokinetics
given PO highly protein bound metabolized in liver, excreted through bile
60
warfarin pharmacodynamics
competitively blocks vitamin K at sites of action
61
warfarin contraindications
active bleeding, bleeding disorders
62
warfarin adverse effects
bleeding, hemorrhage
63
warfarin nursing diagnosis
risk for injury: r/t adverse effects of warfarin
64
warfarin planning/intervetions
max therapeutic effect: dosage should be individualized until PT or INR is in therapeutic range
65
warfarin antidote
vitamin K (phytonadione)
66
warfarin pt education
take drug at the same time every day
67
warfarin dose
titrated based on PT and INR
68
enoxaparin (Lovenox)
low molecular weight heparin (powerpoint prototype) used to prevent thromboembolus (DVT) and ischemic complications in clients with unstable angina/select MIs when combined with aspirin
69
enoxaparin (Lovenox) adverse effects
bleeding, anemia, thrombocytopenia, local pain
70
enoxaparin (Lovenox) interactions
anticoagulant effect enhanced by digitalis, tetracyclines, nicotine, and antihistamines
71
enoxaparin (Lovenox) contraindications
hemorrhage, GI ulceration, hemophilia, thrombocytopenia, liver disease, renal disease, uncontrolled HTN, recent CNS injury or stroke, recent surgery
72
enoxaparin (Lovenox) nursing interventions
check PTT prior to administration avoid injection near scar tissue use electric shaver
73
enoxaparin (Lovenox) cautions
pts with malabsorption disease, chronic diarrhea, and vitamin C deficiency may experience increased anticoagulation effect
74
values to monitor warfarin therapy
PT and INR
75
A nurse will use extreme caution when administering heparin to a patient with what conditions?
peptic ulcer liver disease after surgery because those patients would have greater risk for hemorrhage or excessive blood loss.
76
priority nursing assessment before administering heparin
aPTT
77
patients taking warfarin must monitor intake of
vitamin K
78
patients taking warfarin should not have
grapefruit juice | chamomile (increased r/o bleeding)
79
A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why she is taking both medications. What is the nurse's most accurate response?
"Warfarin takes 3–5 days to develop anticoagulant effects, and you still need heparin."
80
how long does warfarin take to be effective?
anticoagulant effects do not occur for 3 to 5 days after warfarin is started because clotting factors already in the blood follow their normal pathway of elimination
81
healthy INR for anticoagulant therapy
2-3
82
why give LMWH (Lovenox) over heparin?
low-molecular-weight heparins are associated with less thrombocytopenia than standard heparin.
83
when to use an antiplatelet agent or an anticoagulant?
Anticoagulants are more effective in preventing venous thrombosis. Antiplatelet drugs are used to prevent arterial thrombosis.
84
for CAD, anticoagulant or antiplatelet?
antiplatelet -- CAD has an arterial rather than venous etiology.
85
The nurse is concerned that the health care provider does not order routine aPTTs when the client is receiving LMWH for thromboembolism prophylaxis. When the nurse calls the provider with the nurse’s concern, what will be the response?
aPTTs are not needed. Monitoring of aPTT is not necessary with low-dose standard heparin given sub-Q for prophylaxis of thromboembolism or with the LMWHs.

pharm 140 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions