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Anticoagulant, Antip

Drugs recognition: chap 16

warfarin (Coumadin) Oral Anticoagulants
Vitamin K – “antidote for warfarin” Oral Anticoagulants
heparin Parenteral Anticoagulants
enoxaparin (Lovenox) Parenteral Anticoagulants
bivalirudin (Angiomax) Parenteral Anticoagulants
lepirduin (Refludan) Parenteral Anticoagulants
aspirin Antiplatelet Drugs
dipyridamole/aspirin (Aggrenox) Antiplatelet Drugs
clopidogrel (Plavix) Antiplatelet Drugs
(Aggrastat & Intergrilin) – for unstable angina and acute MI Antiplatelet Drugs
abciximab (ReoPro) – for angioplasty and stent placement Antiplatelet Drugs
Alteplase & Streptokinase – for PE, stroke, and acute MI Fibrinolytics
treat hemorrhage caused by coumarin anticoagulants phytonadione
what to monitor when using coumarin coagulants? PT (prothrombin time)
warfarin side effects birth defects and bleeding
PT goal of patient treated with warfarin 1.3 to 1.5 x PT of the control
INR goal of warfarin normally 2 to 3, in pt with mechanical prosthtic heart valses and systemic embolization: INR = 3 to 4.5
drugs increase anticoagulant effect of warfarin salicylates, cephalosporins
drugs decrease anticoagulant effect of warfarin refampin, barbiturates
drug inhibit absorption of warfarin cholestyramine
drugs inhibit metabolism of warfarin and increase bleeding amiodarone, cimetidine, erythromycin, fluconazole, gemfibrozil, isoniazid, metronidazole, sulfinpyrazone
why do warfarin have many drug interactions? b/c it is almost completely metabolized by CYP enzymes: CYP2C9, CYP1A2, CYP 2C19, Cyp 3A4
Warfain indications deep vein thrombosis, atrial fibrillation, artificial heart valve, used in combination with heparin for MI Keep thrombus from extending, cannot dissolve
what does dosage of warfarin depend on? the patient's PT (prothrombi time)
what to do when bleeding occur during administration of coumarin anticoagulant? withheld the drug until Pt determined, reduction in drug dosage, administer phytonadione (vit K). if INR >20, use fresh frozen plasma or factor IX
what causes HIT (heparin-induced thrombocytopenia) heparin administration
What causes HIT 1? heparin-platelet interaction, leading to platelet aggregation, can continue using drugs
What causes HIT 2? immunoglobulin-mediated platelet inactivation, causing mortality and thrombotic complications, discontinued
alteplase (Activase) streptokinase (fibrinolytic drugs) indication degrade thrombus in MI, stroke, PE (pulmonary embolism)
alteplase (Activase) streptokinase adverse effects hemorrhage
abciximab indication for angioplasty and stent placement
abciximab adverse effect bleeding
tirofiban (Aggrastat) & eptifibatide (Integrilin)indications acute coronary syndrome, adverse effect: bleeding
dosage of heparin depends on aPTT (activated partial thromboplastin time
adequate level of heparin aPTT = 1.5 to 2x normmal
enoxaparin (Lovenox)indications DVT, PE, thromboembolic disorders, CV surgeries, atrial fib, unstable angina
heparin antidote protamine sulfate
spironolactone (Aldactone)classes aldosterone antagonists potassium sparing diuretic
eplerenone (Inspra) aldosterone antagonists potassium sparing diuretic
ethacrynic acid loop diuretics
Created by: prinluu