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NURS 416 > Week 3b Hemostasis > Flashcards

Week 3b Hemostasis Flashcards

1
Q

what are the 3 types of anti platelets?

A

aspirin, clopidogrel (plavix) and glycoprotein

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2
Q

what are the 2 main adverse effects of heparin?

A

abnormal bleeding and heparin induced thrombocytopenia

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3
Q

Heparin induced thrombocytopenia is caused by?

A

abnormal antibodies that activate platelets, causing clots to form and depleting platelet counts in the blood

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4
Q

LMWH can cause which type of negative response?

A

skin necrosis

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5
Q

what are 2 examples of direct thrombin/Xa inhibitors

A

dabigatran and rivaroxaban

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6
Q

what are 3 adverse effects of warfarin (Coumadin)

A

microembolism, osteoporosis and abnormal bleeding

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7
Q

what must you monitor when a patient is receiving Coumadin (warfarin)?

A

INR

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8
Q

thrombolytics are?

A

the only drugs which destroy existing clots

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9
Q

what is an example of a thrombolytic?

A

tissue plasminogen activator (tPA)

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10
Q

what is an uncommon condition which is precipitated by tissue injury and associated with hyper coagulation and hemorrhage?

A

Disseminated Intravascular Coagulation

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11
Q

What are 3 types of coagulation defects?

A

1) Von Willebrand Disease
2) Hemophilia A
3) Hemophilia B

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12
Q

What are 4 types of vascular disorders that cause bleeding?

A

1) Hemmorhagic telangiectasia
2) Vit C deficiency (scurvy)
3) Cushing disease
4) Senile purpura

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13
Q

Antifybrinolytics are used for?

A

preventing the breakdown of fibrin/existing clots, thereby preventing excessive bleeding

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14
Q

when are antifibrinolytics most commonly used?

A

after surgery to prevent bleeding

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15
Q

What is an example of an antifibrinolytic?

A

Aminocaproic acid (Amicar)

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16
Q

Vitamin K is required for?

A

synthesis of clotting factors by hepatocytes (factor II (prothrombin), VII IX and X)

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17
Q

What is calcium’s role in coagulation?

A

needed for factor IV

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18
Q

Vitamin K

A

a fat soluble vitamin synthesized by intestinal bacteria that is an essential cofactor for the synthesis of clotting factors

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19
Q

Causes of vitamin K deficiency

A
  • disorders that reduce fat absorption
  • high alcohol consumption
  • anticonvulsants and some antibiotics
  • use of Coumadin anticoagulants
  • prolonged use of antibiotics
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20
Q

Why can vitamin K deficiency occur in newborns?

A
  • insufficient gut bacteria
  • poor placental transport of vitamin K
  • Low prothrombin synthetic capacity of neonatal liver
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21
Q

LMWHs and rivaroxaban act on?

A

Active factor X

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22
Q

Heparin acts on

A

thrombin

23
Q

Wafarin acts on

A

Prothrombin (factor II)

24
Q

What are some conditions that create increased platelet function?

A
  • atherosclerosis
  • DM
  • Smoking
  • elevated blood lipid and cholesterol levels
  • increased platelet levels
25
Q

what are some conditions that cause accelerated activity of the coagulation system?

A
  • pregnancy
  • use of oral contraceptives
  • post surgical state
  • sepsis/systemic inflammation
  • injury
  • CHF
  • malignant diseases
  • stress
26
Q

arterial thrombi are associated with?

A

conditions that produce turbulent blood flow and platelet adherence

27
Q

Venous thrombi are associated with?

A

conditions that cause stasis of blood flow with increased concentrations of coagulation factors

28
Q

throbocytosis

A

elevations in platelet count

29
Q

erythromelagia

A

painful throbbing and burning of the fingers cause by occlusion of the arteries and platelet aggregates

30
Q

Tx for hypercoagubility due to increased platelet function

A

platelet lowering drugs such as hydroxyurea in high risk cases and aspirin as an adjunct

31
Q

what carries a high risk for adverse pregnancy outcomes?

A

hypercoagubility due to increased clotting activity

32
Q

antiphospholipid syndrome

A

a condition associated with autoantibodies directed against protein-binding phospholipids that result in increased coagulation activity

33
Q

what factors predisposes the vessel to damage, platelet adherence and eventual thrombosis?

A

smoking, elevated levels of blood lipids and cholesterol, hemodynamic stress and diabetes mellitus

34
Q

what is the MoA of aspirin?

A

blocks thromboxane A2 in degranulation as well as COX 1 inhibition resulting in decreased platelet aggregation

35
Q

what is the MoA of clopidogrel

A

blocks ADP receptors in platelets, inhibiting activation and aggregation, thereby extending clotting times

36
Q

Therapeutic effects and uses of clopidogrel

A
  • reduce risk of CVA/MI
  • Reduces thrombolytic events post CVA/MI
  • Prevent DVT
  • Prevent thrombi formation in unstable angina/coronary stents
37
Q

What are some adverse effects of Clopidogrel (plavix)?

A
  • headache, dizziness
  • flu-like syndrome
  • diarrhea
  • bruising
  • upper respiratory tract infection
  • rash, pruritus
38
Q

Serious adverse effect of clopidogrel

A

abnormal bleeding

39
Q

Indications of Glycoprotein (abciximab)

A
  • acute coronary syndrome

- percutaneous coronary intervention

40
Q

MoA of glycoprotein (abciximab)

A

prevents platelet activation and aggregation by blocking glycoprotein

41
Q

adverse effects of glycoprotein

A
  • back and chest pain
  • hypotension
  • abnormal bleeding
42
Q

what can be a sign of internal bleeding?

A

hypotension

43
Q

What is the therapeutic margin of PTT?

A

usually 2x the normal value

44
Q

therapeutic effects and uses of heparin

A
  • acute thromboembolic disorders including DVT, PE, unstable angina and evolving MI
  • prophylaxis for clotting (orthopedics)
45
Q

what are some of the advantages of direct thrombin inhibitors/Xa inhibitors?

A
  • PO
  • high efficacy of preventing stroke
  • convenient
  • minor drug and food interactions
  • predictable PK and PD
  • rapid onset and offset
  • short-half life
  • no need for lab testing
46
Q

what is a risk of immune thrombocytopenia purpura?

A

intracranial hemorrhage

47
Q

what are the therapeutic effects and uses of Amicar?

A
  • aplastic anemia
  • hepatic cirrhosis
  • postoperative cardiac surgery
48
Q

von willebrand disorder is a disorder of decreased…?

A

platelet adhesion

49
Q

petechiae and purpura are common manifestations of?

A

thrombocytopenia

50
Q
  • X-linked recessive disorder (primarily males).
  • Mutation in the factor VIII gene.
    bleeding occurs in soft tissues, the gastrointestinal tract, and the hip, knee, elbow, and ankle joints.
  • Spontaneous joint bleeding usually begins when a child begins to walk.
  • Tx: factor VIII products
A

Hemophilia A

51
Q
  • deficiency of factor IX,

- It is genetically and clinically similar to hemophilia A.

A

hemophilia B

52
Q
  • Spontaneous bleeding (nose, mouth, gastrointestinal tract),
  • excessive menstrual flow,
  • prolonged bleeding time with normal platelet count.
  • Tx: VIII/vWF concentrate
A

Von Willebrand disease

53
Q

Von Willebrand disease is caused by?

A

Deficiency of factor VIII and poor platelet function

NURS 416 (17 decks)

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