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Ch26 Pharm

Coagulation Modifier Drugs

QuestionAnswer
What is hemostasis? The process of stopping bleeding.
What substance forms the clot in the coagulation cascade Fibrin
What are the two coagulation pathways? Intrinsic and extrinsic.
What protein converts plasminogen to plasmin? Tissue plasminogen activator (tPA).
What is the role of plasmin? Breaks down fibrin clots into fibrin degradation products.
Hemophilia is caused by deficiencies in which clotting factors? Factors VII, VIII, or IX.
What happens if a patient with hemophilia is not treated? They can bleed to death.
What is the action of anticoagulants? Inhibit clotting factors to prevent clot formation.
Do anticoagulants dissolve existing clots? No, they only prevent new clot formation.
What lab is monitored with heparin? aPTT.
What lab is monitored with warfarin? PT/INR International Normalized Ratio
Therapeutic INR range for warfarin? 2–3.5 depending on condition.
What are LMWH examples? Enoxaparin (Lovenox), dalteparin (Fragmin).
What is the antidote for heparin overdose? Protamine sulfate.
What is the antidote for warfarin overdose? Vitamin K (phytonadione).
Name the antidote for dabigatran. Idarucizumab (Praxbind).
Name the antidote for rivaroxaban & apixaban. Andexxa.
Major adverse effect of anticoagulants? Bleeding.
What is heparin-induced thrombocytopenia (HIT)? Immune reaction → ↓ platelets → paradoxical clotting.
What foods affect warfarin therapy? Vitamin K–rich foods (leafy greens, tomatoes).
Warfarin adverse effect unique to skin? Skin necrosis and “purple toes syndrome.”
Why is bridge therapy used with heparin and warfarin? Heparin acts immediately until warfarin becomes therapeutic.
What do Factor Xa inhibitors do? Block activity of factor Xa, preventing clotting.
Examples of Factor Xa inhibitors? Fondaparinux, rivaroxaban, apixaban, edoxaban, betrixaban.
What is the mechanism of direct thrombin inhibitors? Inhibit thrombin (factor IIa).
Examples of direct thrombin inhibitors? Argatroban, bivalirudin, dabigatran.
What do antiplatelet drugs prevent? Platelet adhesion & aggregation.
Common antiplatelet drugs? Aspirin, clopidogrel, prasugrel, ticagrelor, dipyridamole.
What is a contraindication for aspirin in children? Risk of Reye’s syndrome.
What is the mechanism of GP IIb/IIIa inhibitors? Prevent fibrinogen from binding platelets.
Examples of GP IIb/IIIa inhibitors? Abciximab, eptifibatide, tirofiban.
What is the main adverse effect of antiplatelet drugs? Bleeding.
What do thrombolytic drugs do? Break down preformed clots.
Examples of thrombolytics? Alteplase, tenecteplase, streptokinase.
Indications for thrombolytics? Acute MI, ischemic stroke, PE, DVT, occluded catheters.
Most common adverse effect of thrombolytics? Bleeding (internal, intracranial, superficial).
What is the nursing action if superficial bleeding occurs during tPA infusion? Apply pressure, monitor site — do not stop infusion.
What do antifibrinolytic drugs do? Promote clotting by preventing fibrin breakdown.
Examples of antifibrinolytic drugs? Aminocaproic acid, tranexamic acid, desmopressin.
Indications for antifibrinolytic drugs? Hemophilia, von Willebrand disease, surgical bleeding.
Major adverse effect of antifibrinolytic drugs? Rare; but may cause dysrhythmias, hypotension, GI upset.
Where should subQ heparin injections NOT be given? Within 2 inches of umbilicus, scars, wounds, or drains.
Should subQ heparin be massaged or aspirated? No, may cause hematoma.
What patient education is important with warfarin? Wear medical alert bracelet, consistent vitamin K intake, report bleeding signs.
Which herbals ↑ bleeding with anticoagulants? Garlic, ginger, ginkgo, feverfew, St. John’s wort, dong quai.
Created by: Arkesha24
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