Lecture 3 Flashcards
Generic names for anti platelets
Aspirin
Clopidogrel
Therapeutic effects for aspirin and clopidogrel
Prevents thrombi formation (DVT)
Prevent MI/stroke/ acute coronary syndrome
Prevents recurring clots (status/post MI, ACS, stents, peripheral artery disease)
Adverse effects of anti platelets
Dyspepsia, gastric bleeding
Prolonged bleeding time; thrombocytopenia
Specific adverse effects for aspirin
Tinnitus, hearing loss
Reye’s syndrome
Teachings for clopidogrel and aspirin
Injury/ bleeding prevention
Avoid other NSAIDS, anticoagulants, thrombolytics
Stop as directed prior to invasive tests or surgeries
MOA for anti platelets
Interferes with normal platelet function: platelet activation, adhesion, aggregation, or procoagulant
MOA for Heprin
Increase the effects of anti thrombin III which inactivates thrombin
Routes for heprin
IV/ SubQ
SubQ considerations for heprin
No alcohol to site or allow to dry completely
No aspiration
Apply light pressure with gauze
Therapeutic effects of heprin
Prevent thrombi formation
Treats existing thrombus, embolus
Decreases signs of DVT or PE
Prevents recurring clots
Prevents stroke and MI
Lab test for heprin
PTT
Averse effects of heprin
Bleeding tendencies:
Skin bruising
mucus membranes- bleeding gums, nose bleeds
Stool
Urine
Heprin induced thrombocytopenia (HIT)
Antidote for heprin
Protamine sulfate
MOA for enoxaparin
Low molecular weight heprin, so MOA is similar but it’s specific to factor X
What happens is a patient develops HIT
They will be started on argatroban (direct thrombin inhibitor)
MOA for warfarin
Blocks hepatic production of coagulation factors (vitamin K)
Interferes with the transfer to prothrombin
Lab tests for warfarin
INR
Check bleeding times
Antidote for warfarin
Vitamin k
Generic names for new oral anticoagulants (NOACs)
Rivaroxban
Dabigatran
MOA for rivaroxban
Activated factor X inhibitor
MOA for dabigatran
Direct thrombin inhibitor which prevents fibrin clot
Labs for rivaroxban
aPTT and PTT
Generic name for thrombolytics or tissue plasminogen activator
Alteplase
Antidote for alteplase
Aminocaproic acid
MOA for cyanocobalamin
It is a form of B12 and it gives the dietary B12 necessary for RBC synthesis
What’s cyanocobalamin for?
Treatment of erythrocytopenia or anemia:
It increases RBC, Hct, Hgb
And treats signs and symptoms of anemia
Signs and symptoms of anemia?
SOB
Paleness, pallor
Fatigue, weakness
DizzIness
Low energy
Adverse effects of cyanocobalamin
It’s uncommon: rash, diarrhea, hypokalemia
Teaching for cyanocobalamin
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
MOA for epoetin alpha
Increases hormone erythropoietin which stimulates bone marrow to produce RBCs and erythropoietic growth factor
What does epoetin alpha treat
Erythrocytopenia and anemia
Adverse effects of epoetin alfa
Edema, HTN, headaches
NVD
Teachings for epoetin alfa
Monitor BP and weight regularly
Route for epoetin alfa
SubQ/IV 3x a week
MOA for ferrous sulfate
Gives dietary element iron necessary for RBC synthesis
Adverse effects for ferrous sulfate
NVC
Dark stools
The liquid oral form can stain teeth
Iron toxicity in children
Teachings for ferrous sulfate
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
MOA for folic acid
Gives dietary element folic acid necessary for RBC synthesis
Adverse effects for folic acid
Minimal
Prototype for an WBC agent
Filgrastim
MOA for filgrastim
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.
What does filgrastim treat
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
Adverse effects of filgrastim
Flu like symptoms
Bone pain
Rare: cv problems like dysrhythmias and tachycardia
Teachings for filgrastim
Infection control measures includes handwashing
And avoid people with infection
Bone pain can be managed with Tylenol or NSAIDs, if not contraindicated
