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Thromboembolic Drugs

Pharmacology

QuestionAnswer
What are the two steps of hemostasis? Platelet plug formation and coagulation
What are the two pathways of coagulation? Intrinsic and extrinsic
What is the action of anticoagulants? Reduce the formation of fibrin
What are the three major groups of thromboembolic drugs? Anticoagulants, antiplateletes, and thrombolytics
Is the half-life of heparin short or long? Short
How can heparin be administered? Only by IV or subQ injection
Where is the optimal site for subQ heparin injection? In the abdomen, two inches from the umbilicus
What are the adverse effects of heparin? Hemorrhage, spinal/epidural hematoma, and heparin-induced thrombocytopenia
What is the primary treatment for heparin induced thrombocytopenia? Stopping the use of heparin
When is heparin contraindicated? In patients with thrombocytopenia; uncontrollable bleeding; immediately after brain, eye, or spinal cord surgery
What are the labs that must be monitored with heparin use? aPTT and INR
What is the normal range for aPTT? 25-38 seconds
What is the normal INR range? 2-3 seconds
Does heparin increase or decrease aPTT time? Increases to 60-80 seconds
How often should the aPTT be monitored in a patient on heparin? Every 4-6 hours
What should you assess for in patients on heparin? S/S of blood loss: Hypotension, tachycardia, bruises, hematomas, headache or syncope, discolored urine. Also assess mental status and mucous membranes
What is the antidote for heparin overdose? Protamine sulfate
Describe the action of protamine sulfate. Has immediate action and last 2 hours.
How is protamine sulfate administered? Usually by IV
What are the advantages of Lovenox? It can be given at home, while heparin cannot..
What patient should never receive Lovenox? Patient in kidney failure (assess creatinine and BUN levels).
True or False: Warfarin has a delayed onset. True
How is warfarin administered? PO
What are the therapeutic uses of warfarin? Prevention of thrombus in atrial fibrillation and as prophylaxis in patients with prosthetic heart valves.
What is the antidote for warfarin overdose? Vitamin K
What should be included in patient teaching for warfarin? Use a soft bristled toothbrush
What labs should be monitored with warfarin? PT and INR
What is a normal PT range? 11-14 seconds
Does warfarin increase or decrease PT range? Increase
Should warfarin be used during pregnancy? No
What are the advantages of direct thrombin inhibitors? No anticoagulation monitoring and usually the same dose is used for all patients
Do the direct thrombin inhibitors have a reversal agent? No
What is the therapeutic use for eliquis? Prevention of stroke and systemic embolism in patient with nonvalvular atrial fibrillation
What is an example of an antiplatelet drug? Aspirin
What are the thrombolytic drugs used for? Acute MI, acute ischemic stroke, and acute massive PE
What drugs are also known as clot busters? Thrombolytic drugs
What are the 3 thrombolytic drugs available in the US? Alteplase, Reteplase, and Tenecteplase
Created by: shrewsburysd