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Pharm Exams > Mod 5- Coagulation Modifiers > Flashcards

Mod 5- Coagulation Modifiers Flashcards

1
Q

Special considerations for children on blood coagulants

A

implement safety/ injury precautions

Know what to do if bleeding begins

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2
Q

How are blood coagulants dosed for children?

A

Based on weight and age

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3
Q

What type of blood coagulant drugs should NEVER be used in kids?

A

“-xaban” drugs, low-molecular weight heparins d/t unknown safety, no indications for antiplatelets or thrombolytics

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4
Q

What blood testing would you want to perform for an older adult on blood coagulants?

A

Kidney/ liver functions- start low & go slow

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5
Q

What are 2 indications for blood coagulants?

A

Thromboembolic disorder- conditions that predispose a person to clots & emboli
Hemorrhagic disorder- excess bleeding occurs

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6
Q

Action of Antiplatelets

A

alter the formation of the platelet plug

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7
Q

Action of Anticoagulants

A

Interfere with the clotting cascade and thrombin formation

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8
Q

Thrombolytic drugs are also called?

A

“Clot busters”

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9
Q

Actions of Thrombolytic drugs

A

break down the thrombus that has been formed by stimulating the plasmin system

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10
Q

Antiplatelet Medications

A 
Aspirin 
clopidogrel 
Dipyridamole 
Eptifatide 
Tucagrelor
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11
Q

Indications for Antiplatelet Agents

A
  • CV diseases that are prone to clogged vessels

- keep grafts open/ patent

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12
Q

What are the effects of Aspirin?

A

anti-inflammatory
analgesic
antipyretic effects

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13
Q

Contraindications for antiplatelet agents

A

allergy
pregnancy
lactation

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14
Q

Cautions for antiplatelet agents

A

bleeding disorders
recent surgery
closed-head injury

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15
Q

ADE of Antiplatelet Agents

A

BLEEDING
CNS: H/A, dizziness, weakness
GI distress

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16
Q

Drug/ Drug interactions of Antiplatelet Agents

A

another drug that affects blood clotting

CYP3A inhibitors- liver iso enzyme responsible for metabolism can affect levels of the drug

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17
Q

What notification should you make for a pt on Antiplatelet Agents?

A

Mark their chart

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18
Q

Antiplatelet Prototype

A

Aspirin

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19
Q

What are ADE of aspirin?

A
  • aspirin toxicity can lead to fever, coma, CV collapse

- dizziness, tinnitus, difficulty hearing & anaphylactoid reaction

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20
Q

What are the suffixes for Anticoagulant Agents?

A 
"-arin"
heparin 
warfarin 
"-xaban"
rivaroxaban 
apixaban 
Dabigatran
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21
Q

You wouldn’t give Anticoagulant Agents to pt with these

A

allergy, pregnancy, renal or hepatic disorders

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22
Q

Use caution when giving Anticoagulant Agents to these pts with these

A

CHF
thyrotoxicosis
senility
psychosis

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23
Q

ADE of Anticoagulant Agents

A

Bleeding, GI Upset, Alopecia & dermatitis

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24
Q

Drug/Drug interactions of Heparin

A

Oral anticoagulants, salicylates, penicillins, or cephalosporins (inc. bleeding time)

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25
Q

Drug/ Drug interactions of Heparin

A

nitroglycerin- decreases bleeding time

26
Q

Drug/ Drug interactions of warfarin

A

Number of interactions- check drug guide

27
Q

Why is a pt on Anticoagulant Agents dx with disturbed body image?

A

alopecia & skin rash as a side effect

28
Q

What hx do you need to know about a pt on Anticoagulant Agents

A

recent surgery, bleeding, CVA in last 2 mo, obstetrical delivery, GI bleeding, uncontrolled hypertension, liver disease

29
Q

What are the therapeutic blood levels of warfarin?

A

INR of 2-3
or
PT of 1.5-2.5x the control value

30
Q

What are the therapeutic blood levels of heparin?

A

aPTT of 1.5-3x the control value

31
Q

What is the warfarin antidote?

A

Vitamin K

32
Q

What is the heparin antidote?

A

Protamine sulfate

33
Q

Anticoagulant Agent Prototype

A

Heparin

34
Q

What is the suffix of Thrombolytic Agents?

A 
Think busting up clots- digesting is 
"-ase" 
altepase 
reteplase 
tenecteplase 
urokinase
35
Q

Indications for Thrombolytic Agents

A

When does a clot need to be busted? Acute MI, pulmonary embolism, ischemic stroke

36
Q

Contraindications for Thrombolytic Agents

A

allergy, pregnancy, (caution lactation), any condition that would be worsened by dissolution of clots (bleeding, recent surgery/ births)

37
Q

ADE of Thrombolytic Agents

A

bleeding, cardiac arrhythmias, hypotension, hypersensitivity- rash, flushing, bronchospams, anyphylactic reactions

38
Q

Drug/ Drug interactions of Thrombolytic Agents

A

anticoagulants

antiplatelet

39
Q

What is an important thing to monitor for a pt taking Thrombolytic Agents

A

signs of bleeding, occult blood in stool

40
Q

Thrombolytic Agent Prototype

A

Urokinase

41
Q

What is the benefit of low-molecular-weight Heparins

A

Don’t affect thrombin or clotting times so less systemic effects

42
Q

What do low-molecular weight heparins block?

A

Block factors Xa and Ila

block angiogenesis that allows cancer cells to develop new blood vessels

43
Q

When are low-molecular weight heparins indicated?

A

prevention of clots/ emboli after surgery (joint replacement/ long bone fractures) or bed rest

44
Q

What are the low-molecular weight heparin medications?

A

Dalteparin

Enoxaparin

45
Q

What are 4 anticoagulant adjuncts? 🍀🥔🏈🥦

A

Lepirudin
protamine sulfate
prothrombin complex concentrate
Vitamin K

46
Q

What medication is a hemorrheologic agent?

A

Pentoxifylline- helps trouble w/ blood flow when it is too thick and causes pain in the legs

47
Q

What bleeding disorders are treated with clotting factors?

A

hemophilia
liver disease
bone marrow disorders

48
Q

What is the action of antihemophilic drugs?

A

replaces clotting factors that are genetically missing or low

49
Q

What are the indications for anyhemophilic drugs?

A

Prevents blood loss from injury or surgery & to treat bleeding disorders

50
Q

How would you know a medication is an antihemophilic?

A

It will have the word “factor” in the name

51
Q

What are contraindications of antihemophilics? 🐄🐁🐹🍼 + cautions

A

Allergy to bovine, mice, or hamster; lactation, caution in pregnancy

52
Q

ADE of antihemophilics

A

HA, flushing, fever, chills lethargy
nausea/ vomiting
stinging, itching, burning at injections site

53
Q

How are antihemophilic agents administered?

A

by IV ONLY

54
Q

Antihemophilic Prototype

A

Antihemophilic factor

55
Q

What is the action of a systemic hemostatic agent?

A

Prevents systemic clot breakdown to prevent blood loss

56
Q

What is the indication of a topical hemostatic agent?

A

for surface injuries involving so much damage that clotting does not occur and blood is slowly and continually lost

57
Q

What is a systemic hemostatic medication?

A

aminocaproic acid

58
Q

What is a topical hemostatic medication?

A

absorbable gelatin, thrombin

59
Q

Contraindications to systemic/ topical hemostatic agents

A

systemic: allergy, acute DIC, lactation
Topical: allergy to bovine

60
Q

Caution in systemic/ topical hemostatic agents

A

systemic: cardiac disease, renal/hepatic dysfunction, pregnancy
Topical: no safety established in kids

61
Q

ADE of systemic/ topical hemostatic agents

A

systemic: excess clotting, CNS, GI weakness, fatigue malaise, muscle pain
Topical: infections w/ sponges

62
Q

Drug/Drug interactions of hemostatic agents

A

systemic: heparin, oral contraceptives or estrogen

Pharm Exams (25 decks)

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