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Pharmacology > Hematologics: Antiplatelet, Anticoagulant, Antithrombotic > Flashcards

Hematologics: Antiplatelet, Anticoagulant, Antithrombotic Flashcards

1
Q

Coagulation

A

Formation of an insoluble clot

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2
Q

What disease processes need to be Tx c hematologic medications?

A
  1. DVT
  2. Hx of stroke/MI
  3. Pulmonary Emboli
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3
Q

Steps of coagulation

A
  1. Local vasoconstriction
  2. Formation of platelet aggregation
  3. Formation of blood clot/4 subcategories
  4. Clot retraction and dissolution
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4
Q

Formation of blood clotting

A
  1. Intrinsic
  2. Extrinsic
  3. Common pathway
  4. Conversion of prothrombin to thrombin
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5
Q

Intrinsic

A

Belonging naturally

Essential

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6
Q

Extrinsic

A

Not part of the essential nature of someone or something

Coming or operating from outside

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7
Q

Fibrinolysis

A
  1. Clot removal
  2. Initiated by release of tissue plasminogen activator (tPA)
  3. Circulation restored
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8
Q

Antiplatelet Medication

A
  1. Interferes c platelet aggregation
  2. Prolongs bleeding time
  3. Platelet aggregation occurs p vasoconstriction
  4. Platelet enzymes cause increased platelet activity
  5. Affects ADP & TXA2
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9
Q

Name 3 antiplatelet medications

A
  1. Aspirin (ASA)
  2. Ticlopidine (Ticlid)
  3. Clopidogrel (Plavix)
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10
Q

Therapeutic uses for antiplatelet medication

A
  1. Prevent clot formation
  2. Tx thrombosis- clot in particular area
  3. Tx emboli- clot breaks off & travels
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11
Q

Contraindications for antiplatelet medication

A
  1. Underlying bleeding disorders
  2. Severe liver impairment
  3. Active bleeding
  4. pregnancy
  5. ASA
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12
Q

Antiplatelet Rx Interaction

A
  1. Anticoagulant= Increase risk of bleeding
  2. Antigout medications
  3. NSAID’s c clopidogrel= Iincrease antiplatelet
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13
Q

Antiplatelet adverse effects

A
  1. Bruising & petechiae
  2. GI: N/V/D & pain
  3. Headache/dizziness/weakness
  4. ASA= Hearing changes
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14
Q

RN implication/Teaching for antiplatelet

A
  1. H&P
  2. Monitor I&O (dehydration)
  3. Watch for bleeding
  4. D/C MED 7-10 DAYS PRIOR TO SURGERY, DENTAL WORK
  5. Monitor for hearing loss/dizziness/LOC
  6. Take c food to decrease stomach upset
  7. Avoid activities c possible increase bleeding
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15
Q

Anticoagulant medication

A
  1. Prolongs bleeding time by interfering c clotting

2. Given when pt has a high risk of developing thrombosis

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16
Q

Name 3 Anticoagulant medications:

A
  1. Warfarin (Coumadin)
  2. Heparin
  3. Enoxaparin (Lovenox)
17
Q

Warfarin Action

A

Interferes c vitamin K

Reduces synthesis of vitamin K

18
Q

Heparin Action

A

Prevents conversion of prothrombin to thombin & conversion of firbrinogen to fibrin.

19
Q

Warfarin Specific points

A
  1. Atrial fib
  2. CHF
  3. Valvular disease
  4. Pulmonary embolus
  5. DVT
  6. Take 3-5 days for therapeutic dose
  7. Long term Tx use oral
  8. Eat balanced meal
  9. Monitor c PT= 1.5-2 x baseline=Therapeutic range
20
Q

Heparin specific points

A
  1. Quick onset
  2. DIC
  3. IV/Subcut
  4. Antidote=Protamine sulfate
  5. PTT=1.5-2.5 x baseline= therapeutic range
21
Q

Enoxaparin specific points

A
  1. same as Heparin, 1/2 life is longer
  2. Subcut
  3. Monitor for DVT
  4. Monitor for bruising
  5. Antidote= Protamine sulfate
22
Q

Anticoagulant Contraindication

A
  1. Active bleeding
  2. Head injury
  3. Recent injury
  4. Advanced liver & renal disease
23
Q

Anticoagulation Rx Interaction

A
  1. Other antiplatelet/antithrombotic med
  2. Spinal-epidural anesthesia
  3. Foods c vita K
  4. Some herbs
  5. warfarin
  6. Alcohol
24
Q

Anticoagulation Adverse Effects

A
  1. Bleeding
  2. Hypersensitivity
  3. N/V/D
  4. Heparin=HITT
25
Q

Anticoagulation RN Implication/Teaching

A
  1. Know labs associated
  2. Appropriate route
  3. Have antidote available
  4. Teach pt to watch for signs of bleeding
  5. Use soft tooth brush
  6. Warn pt of effects of alcohol
26
Q

Anticoagulation Assessment

A
  1. Health Hx

2. Assess coagulation studies initially

27
Q

Anticoagulant RN Dx

A
  1. Risk for injury(Bleeding)
  2. Activity Intolerance(Contact sports)
  3. Ineffective tissue perfusion
  4. Impaired tissue integrity
  5. Risk for infection
  6. Deficient knowledge, related to Rx therapy
28
Q

Anticoagulant Planning

A

Client goals & expected outcome

  1. Reduction in blood coagulation
  2. Verbalizes understanding of anticoagulation therapy
29
Q

Anticoagulant Implementation

A
  1. Monitor for adverse clotting reaction & skin necrosis

2. Monitor bleeding values

30
Q

Anticoagulant labs to monitor

A
  1. PT
  2. INR
  3. PTT
  4. CBC
31
Q

Thrombolytics

A
  1. Breaks down/Dissolves existing clots
  2. Prevents clots
  3. Converts plasminogen to plasmin(breaks down fibrin)
  4. Used in some life-threatening situations
32
Q

Name 1 Antithrombolytic

A

Alteplace

33
Q

Antithrombolytic usage

A
  1. Acute MI
  2. Massive PE
  3. DVT
34
Q

Antithrombotic Contraindication

A
  1. Active bleeding
  2. Recent CVA
  3. Severe HTN
  4. Recent surgery
  5. Pregnancy/postpartum
  6. End stage renal/Liver disease
35
Q

Antithrombotics Interaction

A
  1. Anticoagulant
  2. Antiplatelet
  3. Aminocaproic acid is antidote
36
Q

Antithrombolytic Adverse Effect

A
  1. Hemorrhage
  2. Anemia
  3. Hypersensitivity
37
Q

Antithrombolytic RN Implication/Teaching

A
  1. Hx
  2. Given only IV
  3. Monitor for bleeding
  4. Monitor for anaphylactic reaction
  5. Have antidote ready
38
Q

Antithrombolytic Assessment

A
  1. Hx
  2. Vital signs
  3. Assess lab vlues

Pharmacology (19 decks)

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