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Adult Health > Parenteral Anticoagulation Drugs > Flashcards

Parenteral Anticoagulation Drugs Flashcards

1
Q

How do anticoagulant drugs work?

A

They prevent the formation of fibrin which is needed to clot blood

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2
Q

What is another name for an anticoagulant?

A

Antiothrombotic

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3
Q

Which 3 drugs interrupt the conversion of fibrinogen to fibrin?

A

-Unfractionated heparin
-Low-molecular weight heparin
-Fondaparinux heparin

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4
Q

How does heparin prevent clots?

A

-Heparin binds with antithrombin III which inactivates thrombin
-This inhibits the conversion of fibrinogen to fibrin
-Clot is prevented

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5
Q

What are contraindication for heparin therapy?

A

-Uncontrollable bleeding
-Hemorrhagic cerebrovascular accident
-Thrombocytopenia (low platelet count)
-Before, during, or after surgery involving the eyes, spine, or brain
-Before, during, or after lumbar puncture

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6
Q

What drugs have serious interactions with heparin?

A

-Other anticoagulants
-Platelet aggregation inhibitors
-NSAIDs
-Thrombolytics
-Antibiotics

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7
Q

What is a normal aPTT value?

A

25-38 seconds

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8
Q

What is a therapeutic aPTT value for someone taking heparin therapy?

A

1.5-2xs normal

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9
Q

What is important to remember when administering SQ heparin in the abdominal area?

A

Don’t administer it within 2 inches of the belly button

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10
Q

What can be administered as an antidote to a patient that has active bleeding during heparin therapy?

A

Protamine sulfate

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11
Q

What is HIT?

A

Heparin-induced thrombocytopenia; dangerously low platelet count due to heparin

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12
Q

What are the symptoms of HIT?

A

-Bleeding gums
-Bruising
-Bloody urine/stool
-Anxiety

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13
Q

When should aPTT be assessed after initiating heparin?

A

4-6 hours after

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14
Q

Name a Vitamin K Anticoagulant

A

Warfarin

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15
Q

What is the difference between Warfarin and Heparin?

A

-They work on different parts of the clotting cascade
-Warfarin doesn’t require strict monitoring

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16
Q

What is the lab test that is performed before Warfarin is adminisitered?

A

INR; International Normalized Ratio

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17
Q

Describe how Vitamin K Anticoagulants (like Warfarin) work

A

-Vitamin K is needed in order to make clotting factors
-Warfarin interferes with Vitamin K-dependent clotting factors; it also depletes Vitamin K reserves

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18
Q

How long does it take Warfarin to clear from the body?

A

4-5 days

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19
Q

What is a good INR for a patient taking Warfarin?

A

2-3

20
Q

What is the only Oral Direct Thrombin Inhibitor?

A

Dabigatran

21
Q

Name 3 Factor Xa Inhibitors

A

Rivaroxaban
Apixaban
Edoxaban

22
Q

How does Dabigatran work?

A

Directly inhibits thrombin by preventing the conversion of fibrinogen to fibrin

23
Q

How does the Factor Xa Inhibitors work?

A

Directly inhibit Xa preventing the conversion of prothrombin to thrombin

24
Q

What are contraindications of Warfarin?

A

-Thrombocytopenia
-Lumbar puncture; regional anesthesia; surgery of eye, spine, or brain
-Vitamin K deficiency, liver disease, alcoholism
-Pregnancy

25
Q

What are some drugs that interfere with Warfarin?

A

Aspirin
NSAIDs
Sulfonamides
Cimetidine
Allopurinol
Foods high in Vitamin K

26
Q

What are common side effects of Warfarin?

A

Bleeding
GI upset

27
Q

What are adverse drug effects of warfarin?

A

Intracranial bleeding
Retroperitoneal bleeding

28
Q

What is the antidote for a Warfarin overdose?

A

Vitamin K

29
Q

At what INR value should you hold Warfarin?

A

Greater than 3

30
Q

At which age can patients take Dabigatran and Rivaroxaban?

A

18 and older

31
Q

What are contraindications for Dabigatran and Rivaroxaban?

A

Active major bleeding
Mechanical prosthetic heart valve

32
Q

What are drug interactions of Dabigatran and Rivaroxaban?

A

-Rifampin can decrease drug concentrations
-Antacids and PPIs and decrease drug effects
-Antiplatelets, NSAIDs, and other anticoags can increase bleed risks

33
Q

At what dose should you give Rivaroxaban with foods?

A

10mg+

34
Q

If a patent is actively bleeding from Warfarin and not responding to Vitamin K, what should we give them?

A

Fresh-frozen plasma

35
Q

What is the antidote for Dabigatran?

A

Idarucizmab

36
Q

What are antiplatelet drugs?

A

Drugs that suppress platelet aggregation and used in the prevention of thrombosis. They make platelets less sticky so they don’t form clots

37
Q

What are antiplatelet drugs used for?

A
  • Prevention of MI
  • Prevention of ischemic stroke
38
Q

What are the 3 classes of Antiplatelet Drugs? Give a drug name for each

A

-COX Inhibitor; Aspirin
- ADP Receptor Blockers; Clopidogrel
-GP IIb/IIIa Receptor Blockers; Tirofiban

39
Q

What are contraindications for Clopidogrel?

A

Active bleeding

40
Q

What drug interactions are there with Clopidogrel?

A

-Aspirin, NSAIDs, Warfarin may increase bleed risk
-Grapefruit may lessen effects

41
Q

What do thrombolytic drugs do?

A

They disintegrate existing blood clots

42
Q

Name a thrombolytic drug

A

Alteplase

43
Q

Explain how alteplase works

A

Alteplase binds with plasminogen which activates plasmin. Plasmin is an enzyme that disintegrates the fibrin network of blood clots

44
Q

What conditions is Alteplase used for?

A

Acute MI
Acute ischemic stroke
Large, acute PE
Clear clots from central venous catheters

45
Q

What are absolute contraindications of Alteplase?

A

Cranial lesions
History of ischemic stroke within 3 months
Active internal bleeding
Suspected aortic dissection
Uncontrolled hypertension

46
Q

What can be used as an antidote to severe bleeding in a patient taking thrombolytic therapy?

A

Aminocoproic acid

47
Q
A

Adult Health (12 decks)

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