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pharm final- hematology Flashcards

1
Q

clotting process

A

Balance between coagulation and anticoagulation
Need to keep blood in fluid state
Minimize injury and blood loss

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2
Q

result of coagulation system

A

fibrin, a clot-forming substance

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3
Q

injury

A

Vasoconstriction to minimize blood loss
Platelets clump (ADP, Thromboxane A2)
Clotting factors activated
Produced in the liver

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4
Q

virchow’s triad

A

hypercoagulable state
vascular wall injury
circulatory stasis

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5
Q

hypercoagulable state

A 
malignancy
pregnancy and peri-partum period
oestrogen therapy 
trauma or surgery of lower extremity, hip, abdomen ,or pelvis
inflammatory bowel disease
nephrotic syndrome
sepsis
thrombophilia
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6
Q

vascular wall injury

A 
trauma or surgery
venepuncture
chemical irritation
heart valve disease or replacement
atherosclerosis
indwelling catherters
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7
Q

circulatory stasis

A 
**atrial fibrillation
left ventricular dysfunction
immobility or paralysis
venous insufficiency or varicose veins
venous obstruction from tumor, obesity, pregnancy
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8
Q

anticoagulants

A

Inhibit the action or formation of clotting factors
Prevent clot formation
very potent

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9
Q

antiplatelets

A

Inhibit platelet aggregation

Prevent initial platelet plugs

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10
Q

lovenox class

A

anticoagulant

LMWH- low molecular weight heparin

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11
Q

lovenox MOA

A

Block Factor Xa and IIa

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12
Q

lovenox SE

A

not many

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13
Q

lovenox nursing implications

A

Given subcutaneously in the abdomen
Rotate injection sites
Protamine sulfate can be given as an antidote in case of excessive anticoagulation

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14
Q

heparin class

A

anticoagulant

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15
Q

heparin MOA

A

Block formation of prothrombin to thrombin

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16
Q

heparin SE

A

bleeding

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17
Q

heparin nursing implications

A

Intravenous doses are usually double-checked with another nurse
Ensure that subcutaneous doses are given subcutaneously, not IM
Subcutaneous doses should be given in areas of deep subcutaneous fat, and sites rotated
Do not give subcutaneous doses within 1-2 inches of: The umbilicus, abdominal incisions, or open wounds, scars, drainage tubes, stomas
Do not aspirate subcutaneous injections or massage injection site- May cause hematoma formation
IV doses may be given by bolus or IV infusions
Anticoagulant effects seen immediately
Laboratory values done daily to monitor coagulation effects (aPTT)
Protamine sulfate can be given as an antidote in case of excessive anticoagulation

18
Q

coumadin (warfarin) class

A

anticoagulant

19
Q

coumadin (warfarin) MOA

A

inhibits vitamin k synthesis

20
Q

coumadin (warfarin) SE

A

bleeding

21
Q

coumadin (warfarin) nursing implications

A

Stay away from foods with vitamin K- leafy green vegetables
Once a day
May be started while the patient is still on heparin until PT-INR levels indicate adequate anticoagulation
Full therapeutic effect takes several days
Monitor PT-INR regularly—keep follow-up appointments (Normal value- 1.0; Therapeutic value- 2.0)

22
Q

coumadin (warfarin) antidote

A

vitamin k

23
Q

coumadin (warfarin) herbal interactions causin gincreased bleeding

A 
Capsicum pepper
Garlic
Ginger
Ginkgo
St. John’s wart
Feverfew
24
Q

Pradaxa (dabigatran) class

A

anticoagulant

25
Q

Pradaxa (dabigatran) MOA

A

Inhibits thrombin induced platelet aggregation

26
Q

Pradaxa (dabigatran) SE

A

bleeding

27
Q

Pradaxa (dabigatran) nursing implications

A

No lab monitoring involved
PO meds
Uses- DVT prophylaxis, Afib

28
Q

anticoagulant patient education

A

Importance of regular laboratory testing where indicated
Signs of abnormal bleeding
Safety Measures to prevent bruising, bleeding, or tissue injury
Wearing a medical alert bracelet
Avoiding foods high in vitamin K (tomatoes, dark leafy green vegetables)
Consulting physician before taking other drugs or over-the-counter products, including herbals

29
Q

causes of iron deficiency anemia

A

lack of iron in the diet, menstruation, GI blood loss,

30
Q

treatment for iron deficiency anemia

A

iron replacement, red meat, green leafy vegetables, iron fortified cereals/bran, beans

31
Q

iron

A

Supplemental iron may be given as a single drug or as part of a multivitamin preparation

32
Q

Oral iron preparations are available as ferrous salts

A

ferrous fumarate (Femiron), ferrous gluconate, ferrous sulfate (FeSO4)

33
Q

Parenteral preparations

A 
iron dextran (INFeD, Dexferrum)
iron sucrose (Venofer)
34
Q

some foods enhance iron absorption

A 
vitamin C
Orange juice
Veal
Fish
Ascorbic acid
35
Q

some foods impair iron absorption

A 
Eggs*
Corn
Beans*
Cereal products containing phytates
* Also common dietary sources of iron
36
Q

iron SE

A

Most common cause of pediatric poisoning deaths
Causes nausea, vomiting, diarrhea, **constipation, and stomach cramps and pain
**Causes black, tarry stools
Liquid oral preparations may stain teeth (Use straw)
Injectable forms cause pain/irritation upon injection (Z-track method)

37
Q

causes of pernicious anemia

A

lack of B-12 (cyanocobalamin), need intrinsic factor in the stomach to absorb B-12, lack on intrinsic factor, lack of dietary intake

38
Q

symptoms of pernicious anemia

A

paresthesia, large inflamed tongue (glossitis)

39
Q

treatment of pernicious anemia

A

replacement of B12

40
Q

cyanocobalamin

A

Used to treat pernicious anemia and other megaloblastic anemias
Administered orally or intranasally to treat vitamin B12 deficiency
Usually administered by deep intramuscular injection
Meat and dairy products contain B-12

41
Q

epoietin alfa (epogen)

A

Biosynthetic form of the natural hormone erythropoietin
Used for treatment of anemia associated with end-stage renal disease, chemotherapy-induced anemia, and for anemia associated with zidovudine therapy

42
Q

contraindications of epoietin alfa (epogen)

A

drug allergy, uncontrolled hypertension, head and neck cancers, risk of thrombosis

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