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Pharma > Week 9 Medications for Coagulation, Lipids, anemia medications > Flashcards

Week 9 Medications for Coagulation, Lipids, anemia medications Flashcards

1
Q

Examples of anticoagulants

A

Warfarin/Coumadin PO

Heparin IV SQ
-low molecular weigh heparin: Enoxaparin-Lovenox SQ

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2
Q

Enoxaparin med admin:

A

deep SQ in abd 2” from umbilicus,
don’t aspirate,
rotate sites,
Don’t expel air if giving whole prefilled syringe, inject at 90deg, don’t rub site.
½- 5/8”
25-28 gauge needle

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3
Q

warfarin indication

A

Thrombosis prophylaxis (tx for a-fib)

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4
Q

heparin indication

A

Thrombosis prophylaxis (usually in hospital only following ortho surgery, MI, PE..)

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5
Q

note on indication for heparin and warfarin

A

has no effect on blood clots which have already formed

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6
Q

SE AE of heparin and warfarin

A

Heparin-thrombocytopenia
Bleeding

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7
Q

Heparin and warfarin interactions

A

Interaction: NSAID’s, ASA, PCN, Cephalosporin, Ginkgo

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8
Q

heparin and warfarin Contraindication

A

Contraindication:
acute bleeding,
warfarin-Pregnancy

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9
Q

heparin and warfarin pt edu and nsg implications

A

Pt Ed:
Coumadin/warfarin- monitor foods high in vit K (green leafy veggies)

All-monitor for bleeding (pt INR)
ALL Monitor for:
Bruising, gums, abd pain, coffee ground emesis, tarry stool (internal bleeding)
Use electric razor and soft toothbrush.
Doses can be adjusted if pt regularly eats high K+

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10
Q

what is the antidote for a heparin and warfarin OD

A

Warfarin- vit K
Heparin protamine

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11
Q

lab monitoring for dose titration of warfarin and heparin

A

Warfarin pt/INR (2-3)
Heparin aPTT (30-45sec?)
Enoxaparin-Lovenox – no labs needed

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12
Q

Antiplatelet ex

A

Aspirin 81 or 325mg PO
Clopidogrel (Plavix) 75mg PO

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13
Q

Antiplatelet Aspirin and clopidogrel indication

A

Reduce risk of recurrent (transient ischemic attack) TIAs or strokes, PE, and MI prophylaxis

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14
Q

SE AE of aspirin and clopidrogrel

A

bleeding, dyspepsia, abd pain, N/V

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15
Q

clopidogrel and aspirin interactions and nursing implications

A

Interaction:
* NSAIDs, heparin, warfarin

Nursing Implications: Pt ed: monitor for bleeding, hold med 5-7 days before surgery

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16
Q

Thrombopoetic Growth Factors

A

Oprelvekin

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17
Q

Oprelvekin indication

A

decreases thrombocytopenia and need for platelet transfusion in patients receiving chemo.

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18
Q

Oprelvekin SE AE

A

allergic reaction or anaphylaxis

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19
Q

Thrombolytic agents

A

alteplase

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20
Q

alteplase indication

A

acute MI, PE, acute ischemic stroke, DVT

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21
Q

SE AE of alteplase

A

SE/AE:
bleeding,
cardiac arrhythmias,
hypersensitivity (rash, flushing, bronchospasm, anaphylaxis)

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22
Q

nsg implications of thrombolytic agent alteplase

A

Nursing Implications:
monitor for bleeding,
strictly follow med admin guidelines.

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23
Q

antilipemic drugs

A

HMG-COA inhibitors
Atorvastatin (Lipitor) PO 10-80mg
Simvastatin (Zocor) PO 10-40mg

-statin

24
Q

antilipemic drug
Atorvastatin (Lipitor) PO 10-80mg
Simvastatin
indication

A

treat elevated cholesterol by lowering cholesterol production

25
Q

SE AE of atorvastatin and simvastatin

A

hepatotoxicity, rhabdomyolysis, muscle pain + weakness,
Rhabdo: painful/decrease in urine, onset of muscle pain, tea discolored urine

26
Q

antilipemic drug atorvastatin and simvastatin interaction and contraindication

A

Interaction: Grapefruit juice

Contraindication: Pregnancy X

27
Q

nsg implication of antilipemic drug atorvastatin and simvastatin

A

Will be life long treatment for cholesterol
Report muscle pain and all rhabdo Sx
Avoid grapefruit
Will need monitoring of creatinine kinase
Contraception and pregnancy

28
Q

Bile Acid Sequestrants

A

Colesevelam
can be PO 3 times a day twice daily 6QD
or 1 powder packet daily

29
Q

Colesevelam

A

reduce elevated cholesterol through excretion in feces

30
Q

colesevelam/ Welchol SEAE
-bile acid sequestrants

A

Constipation (elimated through excretion)

31
Q

colesevelam/ Welchol nsg implications: pt ed

A

take with 8oz of water
cannot be taken with other meds
powder form must be mixed with a liquid and never taken dry
all drugs should be taken at least 1 hr before
or 4-6 hours after bile sequestrant

32
Q

Niacin MOA and indication

A

vitamin B3
lipid lowering properties in high doses

33
Q

SEAE of niacin

A

flushing of the face and feeling of warmth
report sensations of tingling in the feet to HCP

34
Q

Omega 3 fatty acids indication and SE

A

reduce cholesterol
belching may be fishy

35
Q

Fibrates

A

Fenofibrate Tricor
Gemfibrozil Lopid
-fibr

36
Q

Fenofibrate and gemfibrozil and indication

A

lowers cholesterol and increase HDL by stopping the breakdown of lipids to lower LDL and raise HDL

37
Q

SE AE of fenofibrate and gemfibrozil

A

SE AE diarrhea, hepatotoxicity

38
Q

fenofibrate and gemfibrozil interaction

39
Q

Cholesterol Absorption inhibitor

A

ezetimibe Zetia

40
Q

Exetimibe indication

A

lower LDL cholesterol and increase HDL by inhibiting absorption of cholesterol in the small intestine brush border

41
Q

Exetimbe (cholesterol absorption inhibitor) Nsg implications

A

report persistent GI upset
constipation
bleeding
yellowing of the skin (indicates liver damage)
monitor liver function

42
Q

Epoetin alfa
(erythropoiesis stimulating agent)
indication

A

treats anemia due to end-stage-renal disease and chemo therapy
by stimulating bone marrow to produce RBC
its a synthetic hormone of natural hormone

43
Q

epoetin alfa SE AE

A

hypertension MI
Stroke
DVT
EDEMA
headache

44
Q

epoetin contraindication

A

uncontrolled hypertension
high hgb

45
Q

nsg implication of epoetin alfa

A

assess for pregnancy and last menses
lab (Hgb and Hct)

46
Q

Iron medications

A

ferrous sulfate FeSO4 PO
ferrous Gluconate PO
Iron dextran IV (only for iron deficient anemia)

47
Q

iron indiciation

48
Q

iron SE AE

A

Constipation (may increase fluids and use stool softner)
it is normal to have black tarry stool
stains teeth

IV- anaphylactic response, stains tissue, Z-track

49
Q

what can iron interact with

A

antacids tetracyline diary affect absorption

50
Q

what is iron contraindicated by

A

ulcerative colitis and peptic ulcer disease

51
Q

iron nsg implications and pt ed

A

avoid caffeine
avoid dairy
avoid antacids and tetracyclines when taking the med by 2 hrs
take with orange juice to improve absorbtion
can be taken with food to improve GI upset
stool may be tarry/black (normal)
liquid forms should be taken with a straw to avoid stains
patients should sit upright 15-30 after oral iron doses to avoid corrosion to the esophagous
admin of iron injections using z track

52
Q

Folic acid indication

A

megoblastic anemia
pregnancy

53
Q

what cause folic acid deficiency

A

absorption issues in the small intestine
malnutrition and alcoholism

54
Q

Cyanocobalamin Vit B12

A

is needed for essential cell growth and division
production of RBC

55
Q

cyanobalamin B12 indication and what it is caused by

A

pernicious anemia
caused by
lack of intrinsic factor in the stomach
unable to absorb oral B12

Pharma (12 decks)

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