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pharmcoag
drugs for coagulation disorders
| Question | Answer |
|---|---|
| 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
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