Pharm anticoagulants Flashcards
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Hemostasis
Hemo = Blood, Stasis = Stop
Thrombosis
formation of a blood clot inside a blood vessel, obstructing the flow of
blood through
take out center line
supine on left side, trendelburg even better
veinous is
hot
arterial is
cold
3-4 hours
you only have that window for blood thinners
dont need to memorize
cascade
extrinsic
stabbing
Antiplatelet agents
slippery - think aspirin
Anticoagulants
cascades of factors - inteferes w/ clotting. Prevent formation of clot is goal****it’s not going to dissolve the clot.
clopidogrel (Plavix®)-
depends on genetics - aloha
dipyridamole/aspirin(Aggrenox®)
2 types of anti-platelets - yes you can, can’t take 2 of the same kind.
heparin warfarin(Coumadin®)
requires a lot of monitoring blood levels
Anticoagulants - C for
cascade
Ginko-Garlic-Ginger-Ginseng
can interfere and cause more clotting
Dipyridamole should be taken on
empty stomach
anti-coagulant =
ANTI - clot
anti-coagulant goal
Goal is to thin blood to prevent thrombus
forming
Can be deadly if both
Heparin &
LMWH given together- Always
double check orders…
never give any of these meds with an…
epidural
heparin monitored by…
APPT time. normal is within 30 - 40 seconds. Therauputic is 60 - 80. Just double it.
Warfarin (Coumadin)
Prothrombin time/ International Normalized Ratio. INR - I is 1. Therapeutic is 2 - 3.5
PT normal time
Normal PT= 11-15 sec
Therapeutic PT= 1.5x normal
what drugs increase warfarin bleeding
Amiodarone, fluconazole, erythromycin,
metronidazole, sulfonamides antibx, cimetidine.
Herbs: dong quai, garlic, ginkgo;
Anticoagulants: Adverse Effects
Heparin-induced thrombocytopenia(HIT) / (ITP)
heparin is***
APTT
ratio of protamine sulfate to heparin
1mg to neutralize 100U Heparin}
Heparin DVT Prophylaxis - how much?
5000U SQ BID-TID
don’t massage sub q
heparin
Vitamin K actual name
Phytonadione
Drug therapy with enoxaparin (Lovenox) must
be closely monitored with activated partial
thromboplastin times (aPTTs) lab tests.
False
TPA or Alteplase (anti-clots) DO NOT
have antidotes
A patient is receiving an IV infusion of heparin & was
started on warfarin therapy the night before. Which
statement is most correct?***
The heparin provides anticoagulation until
therapeutic levels of warfarin are reached.
Urokinase antidote
aminocaproic acid
Thrombolytic Drugs
lytic = lysing
Altaplace no antidote bc….
the ½ life is only 5 min
Fibrinolytic Agents - bleeding is…
more
severe than with anticoagulants and can be difficult to control
A patient is receiving an intravenous infusion of a
thrombolytic drug during treatment for an acute MI.
The nurse notices that there is a slight amount of
bleeding from the antecubital area where venous
lab work was drawn. What should the nurse do
first?
Apply pressure to the site with a gauze pad
Which of the following is not a contraindication
forthe use of thrombolytics?
. Use of acetaminophen (Tylenol®)
patient arrived in the emergency department 2
hours after a stroke & was given an
intravenous (IV) injection of Alteplase®. It is
most important for the nurse to monitor what?
(Select all that apply.)
- Bleeding
- Vital signs
- PT levels
- Allergic reactions
- Electrocardiogram
everything except 3 and 4
