Pharmacology in acute settings Flashcards
Which enzyme does aspirin inhibit?
cycloxygenase 1 and 2
Why does aspirin increases chance of getting gastric ulcers?
Cox 2 helps promote blood flow and increase mucus secretions in the gut to prevent damge from gastric acid
aspirin inhibits cox which then in turn inhibits this pathway. Result in lest protection of the gut lining
Which cox enzyme does aspirin preferentially work on?
Cox 1
What is dyspepsia?
pain or discomfort in the abdominal area - in other words indigestion
What are the main adverse effects of anti platelet drugs?
aggravation of bronchospasm - mayb contraindicated in asthmatics
increased bleeding
Which antiplatelet should be avoided on use of patients with active pathological bleeding or a history of troke /tia? Why?
Prasugrel - increased risk of intercranial presssure.
What are the 3 nursing responsibilities when dealing ith a patient on anti-platelet medication?
Monior risk of bleeding
Monitor bp
Assess risk of drug interactions
Briefly decribe action of anti-platelet drugs
reduced clotting by inhibiting certain clotting factors (which activate platelet receptors) thus preventing activation of platelet receptor reducng stickiness of platelets
Which organ produces clotting factors/proteins and coagulation proteins?
liver
Briefly describe action of anti-coagulaent.
Inhibits certain proteins in thrombus cascade (which aims to convert fibrinogen to fibrin) thus reducing the ability to for blood clot - unlike anti-platelets does not have a direct effect on platelet proteins
What is antithrombin?
an anticoagulant protein found in the body which inhibits the conversion of fibrinogen into fibrin
What type of drug is heparin?
Anti-coagulant
briefly decribe mechanism of heparin
no active anticoagulent properties of its own.
catalyses and enhances binding properties of antithrombin in body preventing fibrin mesh being formed
When administering heparin via IV, what is the type of heparin use?
un fractionated heparin
What is unfractionated heparin?
larger molecules of heparin used
What problems ar associated with un-fractionated heparin?
non-specific binding to different cells means great individual variability
effect on thrombin requires monitoring of blood clotting levels
What’s the benfit of fractionated (low molecular weight heparin) over unfractionated heparin?
smaller molecule less variable effects
administrated via sub cut
dose based on body weight
no need to adjust dosing based on lab results
Briefly describe action of heparin
inhibits enzyme vit k epoxide reductase which recycle used vit k
Why is vit k important in clotting?
used to produce important clotting factor proteins such as fibrinogen.
Why are cascade mechanisms important in our body?
the mechanism can enhance certain effects in the body
What are the 3 main actions of antibacterials on pathogenic bacteria?
Affects cell wall
Affects protein prodcution
Afects DNA reproduction
Which type of bacteria is more harmful and why?
gram negative, has polysaccharides on it’sout layer which are also endotoxins
