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Ch. 51 - Anticon


Initial phase of hemostasis limited blood flow to area and vessel constriction at site
2nd phase of hemostasis thrombin activates platelets, platelet plug
3rd phase of hemostasis fibrin creates mesh around platelet plug which secures platelet plug
4th phase of hemostasis plasmin dissolves clot
how do clot busters work form plasmin to break up clots
intrinsic pathway contact activation pathway
extrinsic pathway tissue factor pathway, which is turned on by trauma to vascular wall
what med inhibits synthesis of clotting factor coumadin only. all others inhibit activity of clotting factors
what anticoag is safe during pregnancy heprin
what lab test should you monitor for heprin aPTT
will heparin break down a clot no
will heparin prevent a clot from forming yes
heprin route IV or sub cut only; cannot give IM or orally because it will cause hematomas
heprin is an animal byproduct, what must you watch out for allergies, specifically HIT - heparin induced thrombocytopenia. If platelet levels fall below 100 don't give heprin
can heparin be used for rapid therapy yes
uses for heparin PE, CVA, DVA, proflaxis, renal dyalysis, and low dose proflaxis for post-op
side effects of heparin bleeding, HIT - heparin induced thrombocytopenia (a heparin allergy, if platelet levels fall below 100 don't give heparin), allergy
contraindications for heparin thrombocytopenia, uncontrolled bleeding, surgery in a highly vascular area
what do you give for a heparin overdose Protamine Sulfate. It only lasts for 2 hours, so you may need to repeat
how is LMWH dosage determined by body weight
what is the big difference between heparin and LMWH With LMWH you don't have to monitor aPTT.
side effects of LMWH bleeding and thrombocytopenia
what is the direct thrombin inhibitor drug we have to know? Angiomax = Bivalirodin and Warfin = Coumadin
route of Angiomax IV only and only in hospital
will Angiomax dissolve existing clots No, angiomax is a direct thrombin inhibitor. Only Thrombolytic drugs dissolve existing clots
How long is Angiomax's 1/2 life very short. Therefore, its need to be on a continuous drip
What are the side effects of Angiomax? bleeding, pack pain, nausea, headache, and it is very expensive
if a pt is on Angiomax and has back pain, what would you recommend take tyelenol, but don't' take asprin
route for warfrin oral
does warfin work right away no, it has a delayed onset b/c it does not work on existing clotting factors.
when will you see effects of warfin may see initial effects in 12 hours, but full peak effect is 3-4 days
what does warfin work on vitamin k clotting factors 7,9,10, and prothrombin
uses for warfin proflaxis of thrombosis,
dosage frequency of warfin 1x a day b/c of longer half life. pts will stay on heparin until warfin levels are up
lab value for warfin PT-INR. INR should be 2-3
what to give for OD of warfin Vitamin k or fresh frozen platelets
can you use warfin in pregnancy no
what anti platelet drugs are we responsible for aprin and Plavix
how does aprin work irreversibly inhibits cyclo-oxygenase and last the life of the platelet which is about 7-10 days
side effects of asprin bleeding, especially GI bleeding
when would a pt get plavix to prevent blockage of a coronary stent post PCI and to reduce risk of thrombolytic evens with pts with angina
route of plavix orally
dosage changes in elderly taking plavix no change for elderly, dosage remains at 75 mg
side effects of plavix diarrha, dyspepsia, rash, abdominal pain, less incidence of GI bleed with aspirin but still a chance, used with caution with other meds, PPI - PROTON PUMP INHIBITORS SUCH AS PRILOSEC WILL DECREASE THE EFFICACY OF PLAVIX
what will decrease the efficacy of plavix proton pump inhibitors such as Prilosec
what med causes diarrhea, dyspepsia, rash and abdominal pain and still runs a risk of GI bleeding PLAVIX
super asprin GP2B3A Inhibitor
how do GP2B3A Inhibitor work inhibit platelet aggregation b/c GP2B3A is a platelet membrane protein used for adhesion and aggregation
route for GP2B3A Inhibitor IV only
side effects for GP2B3A Inhibitor bleeding, not used at home.
when is GP2B3A Inhibitor used acute MI and PCI
coumadin anticoagulate
heprin anticoagulate
angiomax direct thrombin inhibitor
warfin direct thrombin inhibitor
asprin antiplatelet
plavix antiplatelet
GP2B3A Inhibitor antiplatelet
streptokinase thrombolytic drug = clot buster
what thrombolytic drug do we need to know Streptokinase - its a clot buster
uses of Streptokinase MI, DVT, Massive PE
is Streptokinase used outpatient no, b/c it is very dangerous
does Streptokinase prevent clots No, Streptokinase only breaks down existing clots
does Streptokinase break down existing clots yes, it is a thrombolytic drug, that is what they do
time from to use thrombolytic drug in MI should be used within 4-6 hour of symptom onset; NEVER USED if pain has been there more than 12 hours
when should you NEVER use a thrombolytic drug such as Streptokinase after a recent stroke, when there is an active GI bleed, and after recent CPR
side effects of Streptokinase bleeding, which can progress to hemorrhage, antibody production (patients can have an allergy reaction), HPTN, Fever, and cerebral hemmorhage
which drug can cause HPTN Streptokinase, a thrombolytic drug is the only one with a side effect of hptn
Created by: cfulton27