Hematology Flashcards
What is Heparin used for?
- Prevention & tx of venous thrombosis
- Prevention & tx of PE
- Acute coronary syndrome
- Perioperative Anticoagulation for extracorporeal circulation & hemodialysis
What factors does Heparin inhibit?
Xa, IX, XI, & XII
Anticoagulation from heparin depends on adequate amounts of circulating ______
Anti-thrombin (AT)
HIT is manifested by a ____ drop in platelet count or less than ______ can lead to thrombotic events
50%; 100,000
HIT is caused by heparin dependent antibodies to platelet factor ___ that trigger platelet aggregation
IV
Activated clotting time uses the ______ pathway where factor ____ initiates activation of clotting cascade
Intrinsic; XII
Protamine dose
1mg for every 100 units of circulating heparin
Which pts are at risk for having a Protamine reaction?
Pts previously sensitized/exposed to neutral Protamine in NPH
Pt with vasectomy
Multiple drug allergies
Or prior protamine exposure
Competitively inhibit activation of plasminogen to plasmin (an enzyme that degrades fibrin clots, fibrinogen, & other plasma proteins)
Tranexamic acid (TXA)
Does warfarin cross the placenta?
Yes. It has exaggerated effects in fetus, who has limited ability to synthesize clotting factors
For pts on eliquis, epidural or intrathecal catheters should not be removed earlier than ____ after last dose, & next dose should not be administered earlier than ___ after removal
24hrs; 5hrs
Which drugs are factor Xa inhibitors?
Xarelto & eliquis
Which drugs are direct thrombin inhibitors?
Dabigatran (Pradaxa) & argatroban
Massive transfusion is greater than ____ units of RBCs within ___
10 units; 24 hrs
What is the recommendation for massive transfusion?
1:1:1 RBCs, plasma, & platelets
