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Pharm 2 > Hemostatic Agents > Flashcards

Hemostatic Agents Flashcards

1
Q

What are indications for use of aminocaproic acid?

A
  • treatment of excessive bleeding resulting from hyperfibrinolysis or urinary fibrinolysis
  • reduces bleeding and transfusion requirements for patients on cardiopulmonary bypass
  • allows for completion of surgery after stopping oozing in patients with cirrhosis
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2
Q

What can occur with rapid IV infusion of aminocaproic acid?

A
  • arrhythmias
  • bradycardia
  • hypotension
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3
Q

What are adverse effects of amicar?

A
  • CNS: dizziness, headache
  • GI: abdominal pain, cramping, diarrhea, N/V
  • local effect: pain and necrosis and injection site
  • other: fever, malaise, nasal stuffiness, pruritus, rash
  • respiratory: dyspnea
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4
Q

What is TXA’s mechanism of action?

A
  • competitive inhibitor of several plasminogen binding sites to reduce plasmin.
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5
Q

What is the indication for use of TXA?

A
  • bleeding prophylaxis for surgery or trauma
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6
Q

What is NovoSeven RT’s mechanism of action?

A
  • works on the extrinsic pathway
  • recombinant factor VIIa binds to activated platelet receptors or tissue factor
  • which activates factor X and causes generation of thrombin and fibrin
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7
Q

What are indications for treatment with NovoSeven RT?

A
  • congenital factor VII deficiency

- hemophilia A or B

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8
Q

What are complications associated with NovoSeven RT?

A
  • thromboembolic events
  • cerebral ischemia or infarction
  • myocardial ischemia or infarction
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9
Q

What are off-label uses for NovoSeven RT?

A
  • massive bleeding despite surgical intervention, FFP, Cryo, or >6 units PRBC in 12hrs
  • spontaneous intracranial hemorrhage
  • warfarin-induced bleeding that cannot wait for reversal with FFP or vitamin K
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10
Q

What is a major disadvantage of NovoSeven RT?

A
  • cost
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11
Q

What are the 3 type of prothrombin complex concentrate?

A
  • FEIBA
  • Kcentra
  • Profilnine SD
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12
Q

What substances are part of Kcentra?

A
  • factor II
  • factor VII
  • factor IX
  • factor X (inactive)
  • contains heparin
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13
Q

What substances are included in FEIBA?

A
  • factor II
  • factor VII (active)
  • factor IX
  • factor X
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14
Q

What is a disadvantage of FEIBA?

A
  • has active factor VII which can increase risk of thrombosis
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15
Q

What 3 substances make up profilnine SD?

A
  • factor II
  • factor IX
  • factor X
  • no heparin
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16
Q

What are indications for use of desmopressin (DDAVP)?

A
  • diabetes insipidus due to inadequate production of ADH by posterior pituitary
  • Treatment of vWB disease and factor VIII deficiency
  • reduction of intraoperative blood loss and transfusion requirements during cardiac and spinal fusion surgery
17
Q

What are the side effects of DDAVP?

A
  • hyponatremia
  • hypotension/hypertension
  • nausea
18
Q

What is desmopressin’s mechanism of action?

A

Promotes platelet adhesiveness to the vascular endothelium

19
Q

DDAVP results in an increased level of factor ___

A

VIII

vWB

20
Q

What 3 substances are released from the endothelial wall after DDAVP administration?

A
  • von Willebrand factor
  • Tissue-type plasminogen activator
  • Prostaglandins
21
Q

T/F

Amicar is a direct inhibitor of plasmin’s anti-platelet effects.

A

FALSE

its is a direct inhibitor of plasminogen, which indirectly inhibits plasmin

22
Q

How is Dextran’s 40 MOA?

A
  • It’s a large glucose molecule, so it pulls water into the blood
  • This decreases blood viscosity and risk of clot
23
Q

T/F

Dextran 40 does not raise glucose levels

A

True

24
Q

What are 3 side effects of Dextran 40?

A
  • Allergic reaction (d/t IgG antibodies)
  • Increased bleeding due to decreased PLT adhesiveness
  • Rouleaux formation (makes cross-matching of blood difficult)
25
Q

Out of the 3 prothrombin complex concentrates (Kcentra, FEIBA, Profilnine), which one has the greatest risk of thrombosis?

A

FEIBA

b/c its contains active factor VII

26
Q

What step of platelet-clot formation does DDAVP affect?

A

Adhesion

27
Q

Which hemostatic agent would be best to use for spinal fusion?

A

DDAVP

28
Q

With amicar, over how long should the loading dose be administered?

A

Over 1 hour

29
Q

What is raplixa?

A

Basically freeze-dried fibrin that comes in a powder form (a fibrin sealant) used to control bleeding in surgery

Pharm 2 (19 decks)

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