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ch.44 Anticoagulants
Antiplatelets and Thrombolytics
| Question | Answer |
|---|---|
| the 3 drugs that restore circulation | anticoagulants, anti-platelets(antithrombotics)and thrombolytics |
| These prevent platelet aggregation or clumping together of platelets for form a clot? | Antiplatlets |
| These are called Clot busters and attack and dissolve blood clots that have already formed? | Thrombolytics |
| These prevent the formation of clots that inhibit circulation. | Anticoagulants |
| This is the formation of a clot in an artery or venous vessel? | Thrombosis |
| Arterial clots are made of? | both white and red cells with white clots( platlets) starting the process, followed by fibrin formation and the trapping of re blood cells in the fibrin mesh. |
| vein blood clots are from what? | platelet aggregation w/fibrin that attaches to red blood cells. |
| Ischemia | decrease in oxygenated blood to a body part,deficient blood flow |
| Venous problems include? | DVT deep vein thrombosis |
| Arterial problems include? | MI myocardial Infraction(coranary thrombosis), artificial heart valves, CVA's(stroke) |
| how are anticogulants administered? | ORALLY OR PARENTERALLY(subQ, IV) |
| Heparin is a natural substance that is made where? | The Liver |
| primary used of Heparin? | to prevent venous thrombosis which can lead to PE or stroke(also DVT, PE) |
| Heparin action? | heparin-->binds w/antithrombin III-->which inactivates Thrombin--->and this inhibitsfibrinogen from converting to fibrin---> and thus not clot is formed |
| What is Heparins purpose? | anticoagulant,it prolongs bleeding time |
| Why is Heparin given subQ instead of orally? | because it it absorbed poorly through the GI muscosa and most of it is destroyed by Liver enzyme herarinase. |
| What are the 2 lab tests used to test for <clotting factors to monitor for heparin therapy? | PTT-partial thromboplastin time and aPTT-activated thromboplastin time |
| Protamine Sulfate is? | the anticoagulant antagonist to stop hemorrhaging during heparin therapy.(it reverses heparins action) |
| Lovenox(Enoxaparin Sodium) is what? | LMWH-low mecular weight heparin that has less side effects and requires less aPTT test soit can be given in home settings, Heparin can only be given in hospital |
| LMWH(anticoagulant) 1/2 life is what? | 2-4 times longer than heparin so less bleeding will occur |
| Patients taking LMWH'should not take what? | aspirin because it will increase bleeding(instead take acetaminephen)! |
| LMWH's should not be given to what patients? | people w/stroke, peptic ulcers, blood problems |
| Warfarin(coumadin)is? | a oral anticogulant, inhibits hepatic systhensis of vitamin K thus affecting clotting factors |
| what are the 2 test used to monitor the clotting time of oral anticoagulants? | PT-prothrombin time, and INR-international normalized ratio(used more often than PT) |
| what is the set point for INR(Warfarin) | 1.3-2(2-3) values can be higher if patient has mechanical heart valve(2.5-4.5) |
| What are the signs of Warfarin accumulation or overdose? | Petechiae(sm red splotches or dots on skin from hemmoragh), ecchymosis(blue skin because of <oxygen, hematemesis(bloody vomit) |
| what is the antidote(antigonists) for warfarin(coumadin) overdose or excess bleeding? | vitamin K(phytonadione), may take 24-48hrs to be effective |
| Herbs not to be taken with anticoagulants? | garlic, ginko, valerian(<warafarin effects) |
| Hematuria | bleeding in urine |
| Epistaxis | bleeding of nose |
| Petechiae,Purpura | bleeding of the skin |
| Antiplatelets | prevent thrombosis in the arteries by suppressing platelet aggregation.prophylatic use(disease prevention) |
| platelet aggregation can be decreased by taking what? | Aspirin-low doses, it inhibits cyclooxygenase and enzyme needed by platelets to synthesis thromboxane. |
| this antiplatelet is used after MI(heart attacks) or strokes to prevent a second one and to prevent TIA? | Plavix(Clopidogrel) |
| TIA-trancient ishemic attack | Cerebrovascular insufficiency from partial occlusion of cerebral artery by an clot or plaque |
| This antiplatelet prolongs bleeding time, is affected by ginko and garlic, is excreted in urine and feces? | Plavix(Clopidogrel) |
| this is a occlusion of an artery or vein caused by a thrombus or embolus | thromboembolism |
| Deficient blood flow? | Ischemia |
| Necrosis | death(tissue,skin, limb) |
| This drug disintegrates a thrombus or clot if administered at least 4 hours after an AMI.it decreases necrosis resulting from blocked artery | Thrombolytics |
| AMI | acute myocardial infarction-acute heart attack.it decreases necrosis resulting from blocked artery |
| Activase(tPA-alteplase) | a thrombolytic that promotes conversion of plasminogen to plasmin which is a enzyme that digests fibrin matrix of clots. can cause Hemorrhaging |
| This plasminogeninactivator is an antidote for thrombolytics, treat excessive bleeding? | Amicar(aminocaproic) |
Created by:
VRoberts
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