Final Exam Drugs PT. 1 Flashcards
Heparin: MOA
-Indirectly inactivates thrombin and factors Xa
Heparin: Indications
-Needs prompt anticoagulant activity. (Evolving stroke, PE, massive DVT)
-Adjunct therapy for patient having open heart surgery or dialysis where blood is leaving the body
Heparin: Adverse reactions
-Bleeding
-Hematoma with spinal epidural
-Thrombocytopenia
Heparin: What do you monitor?
-Bleeding - Vitals - Bruising - Petechiae - Black tarry stools
Heparin: Nursing Considerations
-High risk medication: Need nurse to double check calculations
-Starts working within 20-30 min
-Protamine sulfate is antidote
Heparin: Labs
Anti-xa
aPTT
make sure to stop IV for 15 min and flush throughly before drawing lab
Enoxaparin: Class
LMW Heparin
Enoxaprin: MOA
Indirectly inactivates factors Xa
Prevent clotting
Enoxaparin: Indications
Given Prophylaxis and for treatment
Home use if needed
Enoxaparin: Adverse reactions
-Can cause HIT
-Thrombocyopenia and bleeding
Enoxaparin: BBW
Potential Spinal hematoma if patient has epidural catheter
Enoxaparin: Nursing considerations
-Do not give with other anti coags
-Can give with warfarin to treat PE or DVT
-Slower onset and longer half life than heparin
Warfarin: Class
Anticoagulant
Warfarin: MOA
-Vitamin - K inhibitor
Prevent synthesis of VII - IX - X and II (prothrombin)
Warfarin: Indications
-Prevention of VTE - DVT - PE
-Patients with A-fib
-Reduce recurrence of MI
Warfarin: Adverse Reactions
-Muscle pain
-Purple toes
Warfarin: Antidote
-Give IV vitamin K
-Give fresh frozen plasma
-Give whole blood
Warfarin: Nursing considerations
-HOLD before surgeries
-AVOID foods high in Vit K because they will reduce the effects
-Wear medical alert bracelet and use soft tooth brush and electric razor
Warfarin: Labs
-Monitor PT/INR –> prothrombin time, international normalized ration
-Once therapeutic range is hit patients must monitor monthly
Normal INR without warfarin
1
Therapeutic INR with warfarin
2-3.5
Apixaban
&
Rivaroxaban: Class
Anticoagulant
Apixaban
&
Rivaroxaban: MOA
Direct inhibitor of factor Xa
Apixaban
&
Rivaroxaban: Indications
-Prevent stroke with patient with AFIB
-Post op thrombo-prophylaxis
Apixaban
&
Rivaroxaban: BBW
- Spinal hematoma with epidural catheter
- Risk of thrombosis if drugs abruptly stopped
Apixaban
&
Rivaroxaban: Nursing considerations
-Decrease effect if taking phenytoin, carbamazepine, rifampin, and st johns wart
-Increase effect: CYP3A4 inhibitors (GRAPEFRUIT JUICE)
-No monitoring
-Heavily envolved in liver so watch liver labs
Apixaban
&
Rivaroxaban
antidote
-Andexxa
Aspirin: Class
NSAID