EDIT Antiarrythmics & Anticoagulants Flashcards
Anticoagulants ______ coagulation of the blood. Examples:
-delay/prevent
-ex: antiplatelet, antifibrinolytic
Define thrombus and embolus?
-Thrombus: blood clot
-Embolus: blood clot that moves through vessels
3 Classes of coagulation modifiers (+what they do):
-anti-platelet, prevent clotting
-anti-coagulant (-in/-ans), thin out blood
-thrombolytic (-ase), bust up clots
Aspirin class, MOA
-class/MOA: antiplatelet (prevents clots, binds to COX-1 and COX-2)
Clopidogrel (use, MOA, side effects)
-MOA: ADP receptor blocker, anti platelet
-side effects: bleeding
interactions w/ Ca channel blockers, NSAIDs
Eptifibatide and tirofiban (MOA/use, side effects/considerations)
-MOA: glycoprotein inhibitor, antiplatelet
-side effects: thrombocytopenia, bleeding
Heparin (MOA, use, side effects–considerations/antidote?)
-MOA: anti factors IIA, IX, and X –> anticoagulant
-side effects: HIT (heparin induced thrombosis), bleeding
-consider: check aPTT, protamine sulfate is antidote
Enoxaparin (lovenox) and dalteparin MOA, side effects + considerations
-MOA: LMWH (factor X)
-Side effects: bleeding, anemia, bruising, nothing life threatening
-Check: HCT, HgB, platelets–bleeding
Warfarin MOA, use, side effects, considerations/antidote
-MOA: inhibits vit K dependent clotting factors
-Use: in afib, prevent clotting in heart
-Side effects: bleeding, muscle pain
-Consider: antidote = Vit K, (watch for too much vit K intake) interacts with erythromycin/sulfa/amiodarone, check INR (therapeutically, 2-3.5)
Rivaroxaban and apixaban (class/MOA, considerations, reversal agent)
-anticoagulant
-MOA: inhibits clotting factor Xa
-considerations: don’t stop abruptly, dose carefully, in
-reversal agent: andexanet alfa
Dabigatran MOA, use, side effects/interactions/considerations–antidote?
-MOA: thrombin inhibitor (anticoagulant)
-prodrug activated in liver
-use: in Afib patients
-Side effects: bleeding, GI bleeding,
-interacts w/ St John’s wort, azoles, HIV protease inhibitors
-Consider: dose is dependent on kidney function, antidote is Praxbind (idarucizumab)
Argatroban MOA, use, side effects/considerations
-MOA: thrombin inhibitor (anticoagulant)
-Contraindicated for severe hepatic dysfunction (use lower dose)
If someone is bleeding from gums, while shaving, from IV site, or has blood in urine/stool, they may be on:
heparin (or anti coagulants)
Thrombolytic drugs are the only anti-clotting drugs that do what?
Lyse clots that are already formed
Thrombolytic drug examples, MOA, side effects
-alteplase
-reteplase
-streptokinase
-MOA: activates plasminogen
-Side Effs: ecchymoses, bleeding, toxicity
NO-NOs w/ anti coagulants
Grapefruit juice, cranberry juice, ginko/ginger/st John’s wort, green tea (vit K)
Don’t take what on heparin?
Potassium (salt-replacements in diet foods)
Anticoagulants have what effect on blood clots?
NO effect
Amiodarone MOA, use, side effects/considerations
-use: ventricular arrhythmias
-MOA: blocks Potassium channels
-Side effects: hypotension, bradycardia, photosensitivity, respiratory issues: Blue Man syndrome, pulmonary fibrosis, pulmonary toxicity
-Considerations: cardiac/respiratory assessment, check potassium levels
A patient w/ Afib and an dysrhythmia may be ordered to undergo cardioversion (T/F)
F
Thrombolytic drugs have a _____ half life, and can be very ______.
-half-life
-toxic–no antidote!
Prasugral and ticagrelor are newer types of what class of medication?
Antiplatelet ADP receptor blockers
What anticoagulant and HF drug does Amiodarone interact with?
-warfarin
-digoxin
