LAB - 7.4 - Thrombolytics and Antiplatelets Flashcards
The general action of thrombolytic agents is the
selective degradation of formed fibrin clots with minimal effect on clot formation.
This is administered for disorders in which an intravascular clot has already formed such as in acute myocardial infarction, pulmonary embolism, acute ischemic cerebrovascular accident (CVA), and deep vein thrombosis (DVT )
Thrombolytics
Thrombolytics are administered for disorders in which an intravascular clot has already formed such as in
acute myocardial infarction, pulmonary embolism, acute ischemic cerebrovascular accident (CVA), and deep vein thrombosis (DVT )
Thrombolytics are used early in the course of myocardial infarction within ___ hours of the onset of the infarct to restore blood flow
4 to 6
Thrombolytics time limitation is not related to drug activity, because thrombolytic agents can break down clots older than ___ hours.
6
Rather, tissue that has been anoxic for more than 6 hours is not likely to benefit from thrombolytic therapy, making the risks to the client greater than the advantages.
NA
The goal of thrombolytic therapy is to quickly restore blood flow to the tissue served by the blocked vessel.
NA
Contraindications for thrombolytics
active internal bleeding, history of CVA, intracranial problems, trauma within the previous 2 months
Examples of Thrombolytics
Alteplase
Streptokinase
Fondaparinux (Arixtra)
If this thrombolytic is administered within 3 hours of onset of ischemic stroke, it significantly improves clinical outcomes especially the patient’s ability to perform activities of daily living
Alteplase
Adverse effects Alteplase
Bleeding complications including GI and cerebral hemorrhages
This thrombolytic’s therapy is instituted within 4 hours of myocardial infarction and is infused for one hour
Streptokinase
Streptokinase therapy is instituted within ___ hours of myocardial infarction and is infused for ___ hour
4
1
For Streptokinase, Thromboplastin time is monitored and maintained at ___ fold the control value
2-5
this is a specific blocker of factor Xa for the prevention of venous thromboembolic events in patients undergoing surgery for hip fracture, hip or knee replacement.
Fondaparinux (Arixtra)
What does Fondaparinux (Arixtra) block?
factor Xa
Antidote for Fondaparinux (Arixtra)
Aminocaprioc acid (Amicar)
these drugs Inhibit the aggregation of platelets in the clotting process, thereby prolonging bleeding time
Antiplatelet Medications
these drugs are used in the prophylaxis of long-term complications following MI and CVA
Antiplatelet Medications
Contraindications for Antiplatelet Medications
in bleeding disorders and known sensitivity
Side effects for Antiplatelet Medications
GI bleeding, bruising, hematuria, tarry stools
is the clot that adheres to the vessel wall
THROMBUS
is the CLOT that floats in the blood
EMBOLUS
is the formation of unwanted clot within the blood vessel, producing life threatening conditions such as:
THROMBOSIS
Conditions where thrombosis can occur:
Acute myocardial infarction
Acute ischemic stroke
Deep vein thrombosis
Pulmonary embolism
Examples of Antiplatelet Drugs
clopidogrel (Plavix)
cilostazol (Pletaal)
acetlysalicylic acid (Aspirin)
this antiplatelet is used in patients who are at risk for ischemic events and those with a history of MI
clopidogrel (Plavix)
this antiplatelet is indicated for the reduction of symptoms of intermittent claudication, allowing increased walking distance
cilostazol (Pletaal)
this antiplatelet is effective in decreasing incidence of Transient Ischemic Attack (TIAs)
acetlysalicylic acid (Aspirin)
Adverse Effects of Antiplatelets
Most common adverse effect is bleeding, which often occurs as increased bruising and bleeding while brushing the teeth.
Headache
Dizziness
Weakness
Nausea
GI distress
Most common adverse effect of antiplatelets
bleeding, which often occurs as increased bruising and bleeding while brushing the teeth.
Adverse Effects of Aspirin
Nausea
Dyspepsia
Heartburn
Epigastric discomfort
GI bleeding
Occult blood loss
Dizziness
Tinnitus
Difficulty hearing
Nursing Interventions for Antiplatelets
Suggest safety measures, including the use of an electric razor and avoidance of contact sports.
Provide increased precautions against bleeding during invasive procedures; use pressure dressings and ice to decrease excessive blood loss caused by anticoagulants.
Provide small frequent meals to relieve GI discomfort
