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drugs for coagulation disorders

steps for clot formation vasoconstriction, formation of platelet plug, activation of clottoing/coagulation cascade, formation of a fibrin clot, fibrinolysis (clot retraction and dissolution)
need these electrolytes for clotting calcium and potassium
CHADS2 score scale that scores who needs to be on anticoagulants (0=low risk, aspirin; 2=high risk, warfarin)
action of acticoagulants inhibit clot formation (occurs at end of cascade)
action of heparin Prolong coagulation time by enhancing the actions of anti-thrombin III
heparin antidote PROTAMINE SULFATE 
duration of heparin 8-12 hours (onset is almost immediate)
monitoring heparin monitor dosages by PT and PTT; Monitor platelets for HIT (heparin-induced thrombocytopenia)
low molecular weight heparin action Prolong coagulation by interfering with active factor X (Derivative of standard heparin with lower risk of bleeding)
advantages of LMWH More stable response than heparin; can be administered at home by family or self (subq-prefilled syringes); Less likely to cause bleeding or HIT; Longer duration (thus slower to be metabolized) and immediate onset
action of warfarin/Coumadin Inhibit hepatic synthesis of Vitamin K thus affects clotting factors II, VII, IX, and X (pt. must have consistent intake of vitamin K in diet) **High alert drug**
onset of warfarin 3-5 days; usually use bridging therapy with LMWH until warfarin sets in
some DDI's for warfarin ASA, Vitamin K, NSAID, sulfa, OTC, ginger, gingko, garlic, green tea, laxatives (esp metamucil)
action of anti-platelet mx's increase bleeding time by suppressing platelet aggregation
uses of anti-platelet mx's Prophylactic use: Prevent myocardial infarction or stroke,Prevent repeat AMI or CVA,Prevent a CVA in a patient with TIA
action of thrombolytics “clot-busters”; quickly restore blood flow to the tissue served by the blocked vessel
oral anticoagulant warfarin/Coumadin
ADP receptor blocker medication clopidogrel/Plavix
action of clopidogrel/Plavix alter the plasma membrane of platelets which makes them unable to receive signals required for them to aggregate
indications for Plavix Prevention of thromboembolic events in patients with a recent history of MI, CVA, or peripheral artery disease. Used following coronary artery stents.
what drug classification is Plavix anti-platelet
normal range for INR 2-3
Created by: leh072487