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Pharmacology Roach

Ch 37 Anticoagulant & Thrombolytic Drugs

Anticoagulants Actions Interfere with the clotting mechanism of the blood
Anticoagulant Uses `Prophylaxis and treatment of DVT `P&T of a.fib w/ embolization `P&T of PE `Adjuvant tx of MI `Prevention of thrombus formation after valve replacement surgery
Parenteral Anticoagulants specifically used for `Prevention of postoperative DVT and PE (major ab sx): of clotting in arterial and heart sx, in equip used for extracorporeal circulation, blood transfusions, and in blood samples for lab purposes: of cerebral thrombosis: DIC: IV patency
Anticoagulant Adverse Reactions `Bleeding `N,V,Ab cramp, D `Alopecia `Rash `Hepatitis, jaundice, thrombocytopenia, blood dyscrasias
Anticoagulant Contraindications `Known hypersensitivity `active bleeding (except caused by DIC) `hemorrhagic disease `TB `leukemia `uncontrolled hypertension `GI ulcers `recent sx of eye/cns `aneurysms `severe renal/hepatic disease `during lactation
LMWHs contraindications patients with a hypersensitivity to pork products alternative fondaparinux (Arixtra)
Anticoagulant Precautions `fever `heart failure `diarrhea `diabetes `malignancy `hypertension `renal/hepatic disease `psychoses `depression `pt udergoing spinal procedures `women of childbearing age (contraceptive) `pt with potential sire for bleeding or hemorrhage
Anticoagulant Herbal Considerations: Warfarin should not be combined with `celery `chamomile `clove `dong quai `feverfew `garlic `ginger `ginkgo biloba `ginseng `green tea `onion `passion flower `red clover `st johns wort `turmeric
Antiplatelet Actions & Uses `decreasing the platelets' ability to aggregate in the arterial system `primarily used to treat patients at risk for acute coronary syndrome, MI, stroke, and intermittent claudication
ADP (adenosine diphosphate) receptor blocker action alter the platelet cell membrane
Glycoprotein receptor blockers action prevent enzyme production
Antiplatelet Adverse Reactions `Heart palpitations `Bleeding `Dizziness Headache `N, D, Constipation, dyspepsia
Antiplatelet Contraindications & Precautions `Pregnant/Lactating `known hypersensitivity `CHF `active bleeding `thrombotic throbocytopenic purpura (TTP) `Cautions in:older adult patients, pancytopenic patients, or renal/hepatic impaitment
Thrombolytic Actions break down fibrin clots by converting plasminogen to plasmin *potential benefits must be weighed carefully against the potential dangers of bleeding
Thrombolytic Uses To Treat `acute stroke or MI by lysis of blood clots in the coronary arteries `blood clots causing pulmonary emoboli and DVT `suspected occlusions in central venous catheters
Thrombolytic Adverse Reactions Bleeding the most common allergic reactions may also be seen
Thrombolytic Contraindications and Precautions `known hypersensitivity `active bleeding `history of stoke, aneurysm, and recent intracranial surgery Cautions in: `recently undergone surgery 10 days `experienced a stroke `hypertension `diabetic retinopathy
Created by: Slmallory83