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
Q

alteplase recombinant (Activase) contraindications

A

hypersensitivity, active internal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

alteplase recombinant (Activase) adverse effects

A

internal or superficial bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

alteplase recombinant (Activase) interactions

A

other anticoagulant and antiplatelet drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

alteplase recombinant (Activase) nursing diagnosis

A

risk for injury: r/t drug induced bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

alteplase recombinant (Activase) planning/intervention

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

antihemophilic factor

A

clotting factor (powerpoint prototype)

replaces normal blood clotting factor in event of deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

antihemophilic factor indications

A

deficiency of clotting factor VIII

hemophilia A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

antihemophilic factor pharmacokinetics

A

given IV

T 1/2: 4-24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

antihemophilic factor pharmacodynamics

A

Factor VIII is an essential component of blood clotting and is required for conversion of prothrombin to thrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

antihemophilic factor contraindications

A

hypersensitivity to mouse protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

antihemophilic factor adverse effects

A

anaphylaxis
urticaria
nausea
chills

36
Q

antihemophilic factor nursing diagnosis

A

risk for injury: hemorrhage r/t deficiency of clotting factor VIII

37
Q

antihemophilic factor planning/interventions

A

max therapeutic effect: refrigerate AHF until used, warm before reconstitution

min adverse effect: administer AHF within 3 hrs of dilution, administer IV only

38
Q

aminocaproic acid (Amicar)

A

hemostatic drug (powerpoint prototype)

stops blood loss by enhancing coagulation

39
Q

aminocaproic acid (Amicar) indications

A

life threatening hemorrhage

40
Q

aminocaproic acid (Amicar) pharmacokinetics

A

given PO or IV

excreted mostly unchanged in urine

41
Q

aminocaproic acid (Amicar) pharmacodynamics

A

blocks action of plasminogen activators

interferes with binding of active plasmin to fibrin

42
Q

aminocaproic acid (Amicar) contraindcations

A

active intravascular clotting disorders

43
Q

aminocaproic acid (Amicar) adverse effects

A

GI distress (n/v/d), headache, dizziness, seizures, hypotension, arrhythmias, tinnitus, nasal congetsion, abdominal cramps, diuresis

44
Q

aminocaproic acid (Amicar) interactions

A

oral contraceptives or estrogen

45
Q

aminocaproic acid (Amicar) nursing diagnosis

A

risk of altered cardiovascular perfusion: r/t volume loss 2/2 uncontrolled bleeding or thrombophlebitis

46
Q

aminocaproic acid (Amicar) nursing intervention

A

min adverse effects:
monitor vitals prior to and during therapy
administer via IV infusion pump
monitor I&O and neurologic status

47
Q

aminocaproic acid (Amicar) pt education

A

change position slowly

48
Q

parenteral anticoagulants

A

prevent the conversion of fibrinogen to fibrin

49
Q

oral anticoagulants

A

prevent synthesis of factors dependent on vitamin K

50
Q

heparin pharmacotherapeutics

A

prototype
parenteral anticoagulant that interferes with final steps of clotting cascade
safe for pregnant women
occurs naturally in body

51
Q

heparin pharmacokinetics

A

given IV or subQ

metabolized in liver, excreted in urine

52
Q

heparin pharmacodynamics

A

rapidly promotes the inactivation of factor X, which in turn, prevents conversion of prothrombin to thrombin

53
Q

heparin contraindications

A

hypersensitivity

54
Q

heparin adverse effects

A

bleeding, thrombocytopenia

55
Q

heparin nursing diagnosis

A

risk for injury:
hemorrhage r/t drug therapy
thrombocytopenia 2/2 drug therapy

56
Q

heparin planning/intervention

A

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
Q

heparin antidote

A

protamine sulfate

58
Q

warfarin

A

oral anticoagulant

used prophylactically for pts with long term r/o thrombus formation

59
Q

warfarin pharmacokinetics

A

given PO
highly protein bound
metabolized in liver, excreted through bile

60
Q

warfarin pharmacodynamics

A

competitively blocks vitamin K at sites of action

61
Q

warfarin contraindications

A

active bleeding, bleeding disorders

62
Q

warfarin adverse effects

A

bleeding, hemorrhage

63
Q

warfarin nursing diagnosis

A

risk for injury: r/t adverse effects of warfarin

64
Q

warfarin planning/intervetions

A

max therapeutic effect: dosage should be individualized until PT or INR is in therapeutic range

65
Q

warfarin antidote

A

vitamin K (phytonadione)

66
Q

warfarin pt education

A

take drug at the same time every day

67
Q

warfarin dose

A

titrated based on PT and INR

68
Q

enoxaparin (Lovenox)

A

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
Q

enoxaparin (Lovenox) adverse effects

A

bleeding, anemia, thrombocytopenia, local pain

70
Q

enoxaparin (Lovenox) interactions

A

anticoagulant effect enhanced by digitalis, tetracyclines, nicotine, and antihistamines

71
Q

enoxaparin (Lovenox) contraindications

A

hemorrhage, GI ulceration, hemophilia, thrombocytopenia, liver disease, renal disease, uncontrolled HTN, recent CNS injury or stroke, recent surgery

72
Q

enoxaparin (Lovenox) nursing interventions

A

check PTT prior to administration
avoid injection near scar tissue
use electric shaver

73
Q

enoxaparin (Lovenox) cautions

A

pts with malabsorption disease, chronic diarrhea, and vitamin C deficiency may experience increased anticoagulation effect

74
Q

values to monitor warfarin therapy

A

PT and INR

75
Q

A nurse will use extreme caution when administering heparin to a patient with what conditions?

A

peptic ulcer
liver disease
after surgery

because those patients would have greater risk for hemorrhage or excessive blood loss.

76
Q

priority nursing assessment before administering heparin

A

aPTT

77
Q

patients taking warfarin must monitor intake of

A

vitamin K

78
Q

patients taking warfarin should not have

A

grapefruit juice

chamomile (increased r/o bleeding)

79
Q

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?

A

“Warfarin takes 3–5 days to develop anticoagulant effects, and you still need heparin.”

80
Q

how long does warfarin take to be effective?

A

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
Q

healthy INR for anticoagulant therapy

A

2-3

82
Q

why give LMWH (Lovenox) over heparin?

A

low-molecular-weight heparins are associated with less thrombocytopenia than standard heparin.

83
Q

when to use an antiplatelet agent or an anticoagulant?

A

Anticoagulants are more effective in preventing venous thrombosis.

Antiplatelet drugs are used to prevent arterial thrombosis.

84
Q

for CAD, anticoagulant or antiplatelet?

A

antiplatelet – CAD has an arterial rather than venous etiology.

85
Q

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?

A

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.
© 2024 Bold Learning Solutions. Terms and Conditions