Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
antiplate/coag pt 2
pharm exam 2
| Question | Answer |
|---|---|
| what does unfractioned heparin bind to? | antithrombin and then binds to Xa and thrombin |
| heparin prophylaxis | Low-dose SQ injection |
| heparin treatment | IV bolus and continuous IV infusion Starting dose is indication-based Titrated to aPTT or anti-factor Xa concentrations using institutional nomograms |
| heparin half life | short, reversible with protamine |
| what to monitor when administering heparin | bleeding and thrombocytopenia |
| when would you give a patient protamine? | if they have a lot of bleeding |
| is Type II heparin induced thrombocytopenia immune mediated | yes |
| Type II heparin induced thrombocytopenia nadir platelet count | 50,000 |
| Type II heparin induced thrombocytopenia timing of onset | delayed (day 5); rapid if recent exposure (about 100 days) |
| Type II heparin induced thrombocytopenia incidence | 1-3% |
| Type II heparin induced thrombocytopenia thromboembolic sequelae | 30-50% |
| Type II heparin induced thrombocytopenia treatment | D/C heparin by all routes, select non-heparin anticoagulant |
| is type I heparin induced thrombocytopenia immune mediated? | no |
| type I heparin induced thrombocytopenia nadir platelet count | 100,000 |
| type I heparin induced thrombocytopenia timing of onset | Early (day 1) |
| type I heparin induced thrombocytopenia incidence | 10-20% |
| type I heparin induced thrombocytopenia thromboembolic sequelae | no |
| type I heparin induced thrombocytopenia treatment | observe patient |
| low molecular weight heparin | heparin derived anticoagulant |
| how to give low molecular weight heparin | Injectable (SQ), given once or twice daily (fixed dose) |
| do you monitor a patient after giving them lmwh | no, just look for bleeding |
| is lmwh fully reversible? | no |
| half life of lmwh | longer, caution with procedures |
| what is lmwh used for? | VTE prophylaxis or treatment (weight-based) |
| what is lmwh cleared by? | the kidneys; adjust dose or avoid if renal failure |
| what is Fondaparinux (Arixtra®)? | Synthetic analog of the pentasaccharide binding sequence of heparin Selective factor Xa inhibition |
| Fondaparinux (Arixtra®) | non-heparin anticoagulant |
| how is Fondaparinux (Arixtra®) given? | Injectable (SQ), given once daily (fixed dose) |
| is Fondaparinux monitored? | no, just look for bleeding |
| half life of Fondaparinux | long, not reversible-> caution with procedures |
| what is Fondaparinux used for? | VTE prophylaxis or treatment |
| what is Fondaparinux cleated by? | the kidneys; adjust dose or avoid if renal failure |
| direct thrombine inhibitors | non-heparin anticoagulants |
| direct thrombin inhibitors are used to treat patients with? | documented or suspected HIT |
| What to use when giving patient direct thrombin inhibitors? | institutional nomograms, titrated to goal aPTT |
| DTI- Argatroban is metabolized by? | liver; falsely ↑ INR |
| DTI- Bivalirudin | metabolized by enzymes in blood and partial clearance through kidneys |
| fibrinolytics examples | recombinant tPA, alteplase (Activase®) rPA, reteplase (Retavase®) TNK-tPA, tenecteplase (TNKase®) |
| fibrinolytics mechanism of action | enhance plasmin which breaks down fibrin to dissolve existing clot |
| fibrinolytic indications | ST-segment-elevation myocardial infarction (STEMI) Acute ischemic stroke Pulmonary embolism Peripheral arterial occlusion Clotted catheter |
| fibrinolytic indications- ST-segment-elevation myocardial infarction (STEMI) | Delay in door-to-balloon time (PCI) |
| fibrinolytic indications- acute ischemic stroke | Symptom onset < 3 hrs (or < 4.5 hrs) |
| fibrinolytic indications pulmonary embolism | Hemodynamically unstable |
Created by:
camrynfoster