Lecture 3

Question 1

Generic names for anti platelets

Answer 1

Aspirin

Clopidogrel

Question 2

Therapeutic effects for aspirin and clopidogrel

Answer 2

Prevents thrombi formation (DVT)

Prevent MI/stroke/ acute coronary syndrome

Prevents recurring clots (status/post MI, ACS, stents, peripheral artery disease)

Question 3

Adverse effects of anti platelets

Answer 3

Dyspepsia, gastric bleeding

Prolonged bleeding time; thrombocytopenia

Question 4

Specific adverse effects for aspirin

Answer 4

Tinnitus, hearing loss

Reye’s syndrome

Question 5

Teachings for clopidogrel and aspirin

Answer 5

Injury/ bleeding prevention

Avoid other NSAIDS, anticoagulants, thrombolytics

Stop as directed prior to invasive tests or surgeries

Question 6

MOA for anti platelets

Answer 6

Interferes with normal platelet function: platelet activation, adhesion, aggregation, or procoagulant

Question 7

MOA for Heprin

Answer 7

Increase the effects of anti thrombin III which inactivates thrombin

Question 8

Routes for heprin

Answer 8

IV/ SubQ

Question 9

SubQ considerations for heprin

Answer 9

No alcohol to site or allow to dry completely

No aspiration

Apply light pressure with gauze

Question 10

Therapeutic effects of heprin

Answer 10

Prevent thrombi formation

Treats existing thrombus, embolus

Decreases signs of DVT or PE

Prevents recurring clots

Prevents stroke and MI

Question 11

Lab test for heprin

Answer 11

PTT

Question 12

Averse effects of heprin

Answer 12

Bleeding tendencies:
Skin bruising
mucus membranes- bleeding gums, nose bleeds
Stool
Urine

Heprin induced thrombocytopenia (HIT)

Question 13

Antidote for heprin

Answer 13

Protamine sulfate

Question 14

MOA for enoxaparin

Answer 14

Low molecular weight heprin, so MOA is similar but it’s specific to factor X

Question 15

What happens is a patient develops HIT

Answer 15

They will be started on argatroban (direct thrombin inhibitor)

Question 16

MOA for warfarin

Answer 16

Blocks hepatic production of coagulation factors (vitamin K)

Interferes with the transfer to prothrombin

Question 17

Lab tests for warfarin

Answer 17

INR

Check bleeding times

Question 18

Antidote for warfarin

Answer 18

Vitamin k

Question 19

Generic names for new oral anticoagulants (NOACs)

Answer 19

Rivaroxban

Dabigatran

Question 20

MOA for rivaroxban

Answer 20

Activated factor X inhibitor

Question 21

MOA for dabigatran

Answer 21

Direct thrombin inhibitor which prevents fibrin clot

Question 22

Labs for rivaroxban

Answer 22

aPTT and PTT

Question 23

Generic name for thrombolytics or tissue plasminogen activator

Answer 23

Alteplase

Question 24

Antidote for alteplase

Answer 24

Aminocaproic acid

Question 25

MOA for cyanocobalamin

Answer 25

It is a form of B12 and it gives the dietary B12 necessary for RBC synthesis

Question 26

What’s cyanocobalamin for?

Answer 26

Treatment of erythrocytopenia or anemia: It increases RBC, Hct, Hgb And treats signs and symptoms of anemia

Question 27

Signs and symptoms of anemia?

Answer 27

SOB Paleness, pallor Fatigue, weakness DizzIness Low energy

Question 28

Adverse effects of cyanocobalamin

Answer 28

It’s uncommon: rash, diarrhea, hypokalemia

Question 29

Teaching for cyanocobalamin

Answer 29

Eat well balanced diet If given for pernicious anemia the supplement must be given parenterally monthly And neuro sx could be permanent if treatment is stopped

Question 30

MOA for epoetin alpha

Answer 30

Increases hormone erythropoietin which stimulates bone marrow to produce RBCs and erythropoietic growth factor

Question 31

What does epoetin alpha treat

Answer 31

Erythrocytopenia and anemia

Question 32

Adverse effects of epoetin alfa

Answer 32

Edema, HTN, headaches NVD

Question 33

Teachings for epoetin alfa

Answer 33

Monitor BP and weight regularly

Question 34

Route for epoetin alfa

Answer 34

SubQ/IV 3x a week

Question 35

MOA for ferrous sulfate

Answer 35

Gives dietary element iron necessary for RBC synthesis

Question 36

Adverse effects for ferrous sulfate

Answer 36

NVC Dark stools The liquid oral form can stain teeth Iron toxicity in children

Question 37

Teachings for ferrous sulfate

Answer 37

Oral iron prep: Take with for GI upset Drink liquids via straw Expect dark stools Add fiber to diet Take with vitamin C to enhance absorption Avoid with antacids- take at least 2 hours apart

Question 38

MOA for folic acid

Answer 38

Gives dietary element folic acid necessary for RBC synthesis

Question 39

Adverse effects for folic acid

Answer 39

Minimal

Question 40

Prototype for an WBC agent

Answer 40

Filgrastim

Question 41

MOA for filgrastim

Answer 41

Stimulates bone marrow to produce WBCs; a granulocyte colony which stimulates factor (G-CSF) analog used to stimulate the proliferation and differentiation of granulocytes Filgrastim binds to the G-CSF receptor and stimulates the production of neutrophils in the bone marrow. As a G-CSF analog, it controls proliferation of committed progenitor cells and influences their maturation into mature neutrophils.

Question 42

What does filgrastim treat

Answer 42

Treatment of leukopenia or neutropenia: it increases WBCs and neutrophils Treats the s/sx of leukopenia and neutropenia: Decreases incidence of infection Resolution of existing infection

Question 43

Adverse effects of filgrastim

Answer 43

Flu like symptoms Bone pain Rare: cv problems like dysrhythmias and tachycardia

Question 44

Teachings for filgrastim

Answer 44

Infection control measures includes handwashing And avoid people with infection Bone pain can be managed with Tylenol or NSAIDs, if not contraindicated