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pharm III > exam 3: clotting > Flashcards

exam 3: clotting Flashcards

1
Q

anticoagulation meds

A
  • heparin
  • enoxaparin
  • warfarin
  • apixaban
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2
Q

antiplatelet meds

A
  • aspirin
  • clopidogrel
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3
Q

thrombolytic med

A

alteplase

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4
Q

heparin action

A
  • prevention of thromboembolism
  • inactivated thrombin, thus preventing the fibrinogen converting to fibrin
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5
Q

disorders heparin prevents thromboembolisms with

A
  • PE
  • MI
  • unstable angina
  • artificial heart valves
  • DVT
  • DIC (disseminated intravascular coagulation)
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6
Q

why is heparin given SQ/IV?

A

poorly absorbed in the GI system

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7
Q

heparin s/e

A
  • itching
  • chills
  • hematoma
  • epistaxis
  • hematuria
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8
Q

major s/e of heparin

A
  • anemia
  • bone fractures
  • osteoporosis
  • GI bleeding
  • hemorrhage
  • thrombocytopenia
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9
Q

heparin antidote

A

protamine sulfate

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10
Q

pt education for heparin

A

avoid large amounts of green leafy vegetables d/t vitamin k

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11
Q

enoxaparin action

A
  • prevention of VTE, DVT, or PE
  • treatment of DVT with or without PE
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12
Q

enoxaparin BBW

A

administering two heparin products concomitantly can result in serious harm or death

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13
Q

common s/e of enoxaparin

A
  • bleeding
  • hematoma
  • fever
  • anemia
  • peripheral edema
  • elevated liver enzymes
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14
Q

major s/e of enoxaparin

A
  • hemorrhage
  • hematuria
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15
Q

enoxaparin contraindications

A
  • stroke
  • peptic ulcers
  • hypersensitivity to pork
  • active bleeding
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16
Q

enoxaparin nursing considerations

A
  • should not be given to eye, brain or spinal surgery pts
  • do not expel the air in the syringe
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17
Q

pt education for enoxaparin

A

avoid large amounts of green leafy vegetables, coffee, tea

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18
Q

warfarin action

A

inhibits hepatic synthesis of vitamin k clotting factors

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18
Q

warfarin indication

A

prevention of thrombophlebitis, PE, and embolism formation r/t stroke

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19
Q

common s/e of warfarin

A
  • nausea
  • GI cramping
  • ecchymosis
  • h/a
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19
Q

major s/e of warfarin

A
  • black tarry stool
  • hemorrhage
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20
Q

BBW for warfarin

A

crosses placenta
may cause fetal fatality from hemorrhage

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21
Q

what to monitor during warfarin therapy

A
  • PT/INR
  • hematuria and occult blood stool
  • hepatic function (AST/ALT)
22
Q

pt education for warfarin

A
  • eat balanced levels of vitamin k rich foods
  • use soft toothbrush, floss carefully, utilize electric razor
  • report bleeding
23
Q

apixaban action

A

inhibits the conversion of prothrombin to thrombin in the prevention of clot formation

24
Q

apixaban treats. . .

A
  • DVT
  • PE
  • stroke prevention
  • a-fib
25
Q

common s/e of apixaban

A
  • hematoma
  • anemia
  • bleeding
  • epistaxis
  • hematuria
  • menorrhagia
  • hemoptysis
26
Q

major s/e of apixaban

A
  • bleeding (vaginal, GI, intracranial)
  • hypotension
27
Q

contraindications for apixaban

A
  • active bleeding
  • severe hypersensitivity
28
Q

labs to monitor with apixaban

A
  • CBC, platelet count
  • PT/INR
29
Q

aspirin prevents/treats. . .

A
  • MI
  • TIA
  • a-fib
  • prophylaxis for TE
30
Q

excessive amounts of aspirin can lead to. . .

A
  • SJS
  • anaphylaxis
  • laryngeal edema
31
Q

common s/e of aspirin

A
  • tinnitus
  • dyspepsia
  • GI upset
  • nausea
  • increased bleeding
  • anemia
32
Q

major s/e of aspirin

A

toxicity
- tinnitus
- hyperventilation
- confusion
- lethargy
- agitation

33
Q

labs to monitor with aspirin

A
  • prolonged bleeding time
  • hepatic function
34
Q

pt teaching for aspirin

A
  • avoid alcohol
  • inform HCP of med prior to surgery
35
Q

clopidogrel action

A

inhibition of platelet aggregation- prevention of ADP bonding with the platelet receptor site

36
Q

common s/e of clopidogrel

A
  • abdominal pain
  • dizziness
  • epistaxis
  • h/a
  • hematoma
  • diarrhea
  • constipation
  • purpura
  • peripheral edema
37
Q

MAJOR s/e of clopidogrel

A
  • bleeding
  • peptic ulcer
  • intracranial bleeding
38
Q

life threatening s/e of clopidogrel

A
  • aplastic anemia
  • agranulocytosis
  • SJS
  • pancytopenia
  • thrombocytopenia
39
Q

agranulocytosis

A

severe neutropenia

40
Q

contraindications for clopidogrel

A
  • GI bleed
  • intracranial hemorrhage
41
Q

administer clopidogrel with caution in pts with. . .

A
  • hepatic/renal disease
  • surgery
  • peptic ulcer
  • trauma
42
Q

labs to monitor with clopidogrel

A
  • prolonged bleeding time
  • CBC
  • platelet count
43
Q

pt education for clopidogrel

A
  • effects are decreased with grapefruit juice
  • call PCP if fever, chills, core throat or unusual bleeding/bruising occur
44
Q

med that needs to be discontinued a minimum of 5 days prior to surgery

A

clopidogrel

45
Q

alteplase action

A

promotes plasminogen to plasmin —> breakdown of fibrin clots

46
Q

alteplase treats. . .

A
  • ischemic CVA or PE
  • occluded central lines
47
Q

thromboembolism

A

occlusion of an artery or vein caused by a thrombus or embolus

48
Q

thromboembolism results in. . .

A

ischemia: deficient blood flow possibly causing tissue necrosis in obstructed area

49
Q

common s/e of alteplase

A
  • epistaxis
  • hypotension
  • ecchymosis
  • rash
50
Q

major s/e of alteplase

A
  • anaphylaxis
  • HTN
  • MI
  • cerebral edema
51
Q

life threatening s/e of alteplase

A
  • stroke
  • dysrhythmia
  • pulmonary edema
  • renal failure
52
Q

contraindications for alteplase

A
  • internal bleeding
  • bleeding disorders
  • severe liver dysfunction
  • head trauma
53
Q

use caution with these pts if prescribed alteplase

A
  • a-fib
  • hepatic/renal disease
  • CABG
  • PUD
54
Q

what to monitor when administering alteplase

A
  • PT/aPTT
  • H/H, platelets
  • neuro status
55
Q

avoid administering clotting medications concurrently with. . .

A
  • NSAIDs
  • SSNRIs
  • SSRIs

pharm III (6 decks)

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