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anticoagulation drug
ch. 28 Pharm
| Question | Answer |
|---|---|
| what is hemostasis and what is it also called | clotting of blood, coagulation |
| what is the technical term for a blood clot? | thrombus |
| when a thrombus moves through blood vessels it's known as what | embolus |
| substances that promote coagulation | platelets, von Willebrand factor, activated clotting factors, tissue thormboplastin |
| substances that inhibit coagulation | prostacyclin, antithrombin III, proteins C & S |
| what does tissue plasminogen activator do | natural substance taht dissolves clots taht are already formed |
| what is the coagulation system called | cascade |
| what is the result of a cascade | lg concentration of clot forming subst called fibrin |
| What is the cascade divided in to | intrinsic adn extrinsic pathways |
| What are the two common anticoagulatant drugs | warfarin and heparin |
| what does the fibrinolytic system do | initiates breakdown of clots |
| what is fibrinolysis | reverse of clotting process, the mechanism which formed thrombi are lysed to prevent excessive clot formation adn blood vessel blockage |
| the fibrin in a clot bind to a circulating protein known as | plasminogen which is converted to plasmin |
| what does plasmin do | enzymatic protein that eventually breaks down the fibrin thrombus into fibrin degradation products and keeps thrombus localized to prevent it from becoming an embolus |
| what do anticoagulants do | inhibit the action or formation of clotting factors and prevent clots from forming |
| what do antiplatelets do | prevent platelet plugs from forming by inhibiting platelet aggregation, prevent heart attacks and strokes |
| what do thrombolytic drugs do | lyse(break down) clots or thrombi that have already formed |
| what is the difference b/n thrombolytics and anticoagulants | thrombolytics break clots that have already formed, anticoagulants prevent formation of a clot |
| what are antifibrinolytic drugs | hemostatic drugs, promote blood coagulation and help manage excessive bleeding |
| when you decr blood coagulability, anticoagulants prevent intravascular | thrombosis, uses vary from preventing clot formation to preventing the extension of an est. clot or thrombus |
| when a clot forms and dislodges and travels through the blood stream it's known as a | embolus |
| if it dislodges in a coronary artery, it causes | MI |
| if a clot obstructs a brain vessel, it causes | stroke |
| if clot goes to the lungs it's | pulmonary embolism |
| if clot goes to the leg | deep vein thrombosis (DVT) |
| collectively, these complications are known as | thromboembolic events |
| anticoagulants are also known as | antithrombotic drugs, prevent formation of clot or thrombus (thrombosis), no effect on existing clot used prophylactically on embolus |
| Heparin binds to | antithrombin III, turns off three main activating factos, factor II (thrombin), factor x, factor IX |
| Antithrombin III is what kind of inhibitor in the blood | natural |
| What is overall affect of heparins and low molecular weight heparins(LMW) | turns off the coagulation pathway and prevents clots from forming |
| what can heparin not do | lyse a clot |
| How does Warfarin work | inhibiting vit K synthesis by bacteria in the gastro tract |
| what factors are inhibited with warfarin and where are these synthesized and what are they normally known as | Factors II, VII, IX, X liver vitamin K-dependent clotting factors |
| There are 4 antithrombin drugs, 1 natural and 3 synthetic, name them | natural- human antithrombin III(thrombate) synthetic- lepirudin(Refludan), argatroban(Argatroban), bivalirudin(Angiomax) |
| Warfarin is used to do what to serious events like heart attack, DVT, PE(pulmonary embolism) | prevent |
| Heparin is used to do what to those serious events | treatment and prevention |
| What is the main adverse effect of anticoagulants | bleeding, local or systemic |
| what is an adverse effect of heparin | heparin-induced thrombocytopenia(HIT) also known as heparin-associated thrombocytopenia |
| what are some symptoms of overdose of anticoagulants | bleeding gums, blood in stool, petechiae, ecchymoses |
| what is the treatment of toxicity of heparin | protamine |
| what is the antidote for toxicity for Warfarin | Vit K |
| what lab tests do you perform for heparin | APTT's |
| What are antiplatelet drug indications | reduce risk of fatal and nonfatal strokes, acute unstable angina and MI |
| What do antifibrinolytic drugs do | prevent lysis of fibrin, promote clot formation, used for excessive bleeding |
| Thrombolytic drugs | bust up existing clot |
| Name thrombotytic drugs | throttle the phase anistreplase(Eminase) alteplase(t-PA, Activase) reteplase(Retavase) tenecteplase(TNKase) |
| thrombolytic adverse effects | bleeding: internal, intracranial, superficial |
| Nursing implications on heparin | SC doses, not IM for slow release, not w/in 2" of umbilicus, don't aspirate SC injections, |
| Warfarin nursing implications | PT-INR normalized ratio, can combine with heparin til normal, watch herbals, avoid foods high in vit. K, |
| antiplatelet drugs do what | work to prevent adhesion to the site of blood vessel injury, which actually occurs before the clotting cascade |
| aspirin is what kind of drug, which class is it | antiplatelet |
| what is the difference b/n coagulation system and fibrinolytic system | coagulation system forms clots, fibrinolytic system dissolves clots |
| what about the thrombolytic system | activates fibrinolytic system to break down thrombus in blood vessel quickly so flow is reestablished to coronoary aa. Converts plasminogen to plasmin which breaks down proteins |
| how long should aspirin be withheld in pts going to surgery and who should not get aspirin | 5-7 days, children/teens, bleeding disorders, pregnant, pts with vit K deficiancy or peptic ulcer disease |
| how low can platelets fall before call doctor | <80,000 cells/mm3 |
| Can you administer two antiplatelets at same time | no |
| can you give thrombolytic with heparin, warfarin, aspirin, NSAIDS | no |
| what is purpose of antifibrinolytic drugs | stop bleeding from overdoses of thrombolytic drugs and control bleeding during cardiac surgery |
Created by:
palmerag
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