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318 topics 6-8 > topic 8 hematologic system drugs > Flashcards

topic 8 hematologic system drugs Flashcards

1
Q

what do anticoagulants do

A

inhibit clot formation, phrophylactic

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2
Q

contraindications for anticoagulants

A

clotting issues, head injury, hemorrhagic stroke, head trauma, surgery, spinal surgery, low platelets

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3
Q

CAMS for anticoagulants

A

garlic, ginkgo, ginsing, green tea, bilberry

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4
Q

pt education for anticoagulants

A

don’t take aspirin or anti-platelet drugs, caution w injuries, soft toothbrush, electric razor, wear medical ID bracelet

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5
Q

routes for heparin

A

IV for acute thrombosis
SQ prophylactically

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6
Q

uses for heparin

A

** short 1/2 life, good for hospital use, not at home
prevent thrombosis associated with PE, MI, unstable angina, prosthetic heart valves, DVT, and percutaneous coronary intervention

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7
Q

labs for heparin

A

PTT/aPTT

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8
Q

when do you need to stop heparin before surgery?

A

1 hour

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9
Q

where is heparin poorly absorbed

A

GI tract

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10
Q

antidote for heparin and enoxaparin

A

protamine sulfate

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11
Q

drug interactions for anticoagulants

A

aspirin, thrombolytics, NSAIDs, SSRIs, antibiotics

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12
Q

side effects of warfarin

A

Headache, GI distress, alopecia
Fever, weakness, priapism
elevated hepatic enzymes

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13
Q

adverse effects of heparin and enoxaparin

A

Bleeding, hematoma, anemia, fever, elevated liver enzymes – see antidote

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14
Q

side effects of heparin and enoxaparin

A

itching, chills, hematoma, injection site reaction

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15
Q

how is enoxaparin different than heparin

A

2x longer 1/2 life, only given SQ

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16
Q

can anticoagulants decrease platelet count

A

yes

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17
Q

how is warfarin given

A

PO, long 1/2 life, what pt goes home on

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18
Q

is warfarin high protein bound

A

yes

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19
Q

MOA of warfarin

A

depresses hepatic synthesis of vitamin K clotting factors

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20
Q

antidote for warfarin

A

vitamin K

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21
Q

pt education for warfarin

A

dont eat foods w vitamin K: brocolli, dark leafy greens, olive oil, swiss chard, parsley, tomatoes, squash

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22
Q

what decreases the effects of warfarin

A

laxatives, birth control, vitamin C, K

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23
Q

adverse effects of warfarin

A

Purple-toe syndrome, bone fracture, hypotension
Chest pain, elevated hepatic enzymes
HEMORRHAGE

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24
Q

normal side effects of warfarin

A

headache, GI distress, alopecia, fever, weakness

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25
Q

labs for warfarin

A

INR and PT (platelet count)
INR range 2-3

26
Q

what do antiplatelet drugs do

A

prevent thrombosis by suppressing platelet aggregation

27
Q

use for antiplatelets

A

prophylactic for MI, stroke, transient ischemic attacks

28
Q

use of aspirin

A

blood thinner/antiplatelet, reduce fever and pain, reduces inflammation
** babies can not have, prophylactic dose is 81 mg

29
Q

CAMS for antiplatelet drugs

A

ginsing, garlic, green tea, ginko, saw palmetto (all increase bleeding)
black licorice, St Johns Wort, grapefruit juice

30
Q

labs to run for antiplatelet drugs

A

platelets
normal 150-400k
uner 150 notify HCP

31
Q

normal hemaglobin level

A

less than 7 means heaven

32
Q

what class is clopidogrel

A

antiplatelet

33
Q

what does clopidogrel do

A

inhibits platelet aggregation, prevents thrombosis for unstable angina, MI, stroke

34
Q

onset and duration of clopidogrel

A

given PO rapid absorption
peak time 5-7 hours

35
Q

what do thrombolytics do

A

clot busters
Converts plasminogen to plasmin  destroys the fibrin in the blood clot

36
Q

when does a blood clot disintegrate when a thrombolytic drug is administered

A

within 3-4 hours of thrombolytic stroke
within 30 min of arrival at hospital for acute MI

37
Q

indications of use for thrombolytics

A

thrombolytic strokes, PE, acute MI, DVT

38
Q

contraindications for thrombolytics

A

surgery, head trauma, intracranial bleed, hemorragic stroke, low mehaglobin

39
Q

nursing considerations for thrombolytics

A

assess for hemorrage, watch for stomach pain, headache, use manual BP cuff every 15 min, bleeding out is risk

40
Q

labs to run for thrombolytics

A

CBC to test hemoglobin and hemocrit

41
Q

what class if alteplase

A

thrombolytic

42
Q

how is alteplase given

A

IV, immediate onset

43
Q

drug interactions with alteplase

A

no aspirin or NSAIDs, can have Tylenol (acetaminophen)

44
Q

CAMs for alteplase

A

no gingko, garlic, green tea, omega 3 fatty acids

45
Q

side effects of alteplase

A

nosebleeds (epistasis) and bruising is common

46
Q

indications for use of alteplase

A

PE, thrombolytic stroke, MI

47
Q

contraindications for alteplase

A

hemorrhagic stroke

48
Q

what should the client report w alteplase

A

side effects including lightheadedness, dizziness, palpitations, nausea, pruritus

49
Q

what class is atorvastatin

A

Antihyperlipidemic: HMG-CoA reductase

50
Q

when do you take atorvastatin

A

night time

51
Q

indications for atorvastatin

A

hyperlipidemia, hypertriglyceridemia, arterial sclerosis

52
Q

labs for atorvastatin

A

LDL, HDL, triglycerides, LFT

53
Q

education for atorvastatin

A

report dark urine and muscle pain/spasms, dont stop taking just call
wear sunscreen
takes 3-6 months to work
take w food, have low chol. diet

54
Q

CAMs for atorvastatin

A

st johns wort, black cohosh, green tea

55
Q

can you take atorvastatin while pregnant

56
Q

what class is cilostazol

A

Direct-Acting Vasodilator

57
Q

use of cilostazol

A

To treat peripheral vascular disease and intermittent claudication

58
Q

MOA of cilostazol

A

Acts directly to inhibit platelet aggregation and cause vasodilation, especially in the femoral vasculature

59
Q

when should you take cilostazol

A

30 min before meal or 2 hour after

60
Q

client education for cilostazol

A

take w full glass of water, takes 1.5-3 months to see results, not immediate, change positions slowly

61
Q

CAMs for cilostazol

A

no st johns, licorice, grapefruit, ginger, green tea, gingko

318 topics 6-8 (3 decks)

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