module 6 flashcards
Thrombus
blood clot
Embolus
blood clot that is moving throughout the bloodstream
Heparin route
SubQ or IV drip
Heparin dosage
10-40,000 units
Heparin frequency
BID or TID
Heparin MOA
Turns off coagulation pathway and prevents clots from forming. inactivate thrombin and factor xa
Heparin Adverse effects
Bleeding, hematoma, anemia, thrombocytopenia, heparin induced thrombocytopenia (HIT)
Heparin antidote
Protamine Sulfate
Heparin contraindications
allergy, acute bleeding process/risk
Heparin interactions
Aspirin, NSAIDS, oral anticoags, antiplatelets, thrombolytics (all lead to increased bleeding)
heparin nursing actions
monitor vital signs, observe for bleeding ( increased hr, decreased bp, bruising, black tarry stools), monitor aptt
Enoxaparin route
parenteral only, prefilled syringes with air bubble
Enoxaparin dosage
40mg
Enoxaparin frequency
Once a day
Enoxaparin MOA
inactivate factor xa only
Enoxaparin adverse effects
Black box warning for spinal hematomas if pt has epidural catheter
Enoxaparin antidote
protamine sulfate
Enoxaparin contraindications
indwelling epidural catheter, allergy, acute bleeding process/risk
Enoxaparin interactions
heparin
Warfarin route
oral
Warfarin dosage
dependent on patients INR
Warfarin frequency
same time everyday
Warfarin MOA
Inhibit vitamin K synthesis by bacteria in the GI tract which then inhibits clotting factor production
Warfarin adverse effects
bleeding, NV, abdominal cramps, skin necrosis, purple toes syndrome
Warfarin antidote
vitamin K, when given IV there is a risk for anaphylaxis so you give it diluted and over 30 mins
Warfarin contraindications
Pregnancy, allergy, acute bleeding process/risk
Warfarin interactions
acetaminophen, aspirin, NSAIDS, gingko, broad spectrum antibiotics, barbiturates, rifampin, phenytoin, statins, garlic, st john’s wort
Warfarin nursing actions
administer the oral dose same time each day, assess carefully for excessive bruising/unusual bleeding, monitor INR lab values (2-3 goal range), do not fluctuate diet.
Clopidogrel route
PO
Clopidogrel dosage
300mg loaded dose, 75mg once daily
Clopidogrel frequency
daily
Clopidogrel MOA
alter the platelet membrane so it can’t receive the signal to form a clot
Clopidogrel adverse effects
black box warning for patients with genetic abnormalities, chest pain, edema, flu like symptoms, headache, dizziness, fatigue, abdominal pain, diarrhea, nausea, epistaxis, rash, pruritus
Clopidogrel contraindications
drug allergy, thrombocytopenia, active bleeding, leukemia, traumatic injury, gi ulcer, vitamin k deficiency, recent stroke
Clopidogrel Interactions
dipyridamole, amiodarone, calcium channel blockers, NSAIDs, proton pump inhibitors
INR
international normalized ratio is a calculation based off of pt time
aPTT
Activated Partial Thromboplastin Time.
Measures how long it takes for a blood clot to form
PT
measures how long it takes for a blood clot to form in a blood sample
Anticoagulant
preventing/ delaying blood coagulation (Heparin, Enoxaparin, Warfarin)
Antiplatelet
inhibit platelet aggregation (Clopidogrel)
Prophylactic use
prevention
Combination therapy
never give heparin in combo with enoxaparin, clopidogrel is given in combo with aspirin
