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pharm test 4

ch. 27 coagulation modifier agents

Various Agents: anticoagulants do not break apart clots, but instead keep clots from forming (they are preventive)
various agents: antiplatelet drugs prevent platelets from sticking together so that you dont get a clot (usually given to ppl who have had a heart attack)
various agents: thrombolytics clot busters (used in ER if some one is having a stroke or heart attack
various agents: hemostatic agents mainly used in OR if the pt. starts bleeding too much (they promote blood clotting)
Heparin monitored by activated partial thromboplastin times (aPTTs) **maintain at 1.5-2.5 times the baseline value **normal control 25-35 seconds **therapeutic values 45-70 seconds
what is the antidote for heparin? protamine sulfate
low molecular weight heparins enoxaparin (lovenox) and dalteparin (fragmin) **do not require frequent lab monitoring **give it in the stomach (pinch skin, do not massage, or aspirate)
warfarin (coumadin) -given orally only -monitored by prothrombin time (PT) or INR **INR therapeutic 2.0-3.0 **PT control 12 seconds, therapeutic value 1.5 times control **monitor labs daily until stable dose reached
what is the antidote for coumadin? vitamin K
antiplatelet agents aspirin, dipyridamole (persantine), clopidogrel (plavix)
if you are going to have surgery when should you stop antiplatelet agents? stop atleast 7 days prior to planned surgery
antifibrinolytic agents prevent the lysis of fibrin **promote clot formation **used for prevention and treatment of excessive bleeding resulting from surgical complications
antifibrinolytic agents -aminocaproic acid (amicar) --> most commonly used in surgery -desmopressin (DDAVP) --> similar to ADH, used in treatment of diabetes insipidus
thrombolytic agents break down or lyse clots **streptokinase & urokinase (older agents)--> these can give allergic reactions **TPA (tissue plasminogen activator) **anisoylated plasminogen-streptokinase activator complex (APSAC) **alteplase, reteplase, tenecteplase
what is the antidote for thrombolytic agents aminocaproic acid (amicar)
the nurse is monitoring a pt. who is receiving antithrombolytic therapy in the ER b/c of MI. which adverse effect would be of the greatest concern at this time? irregular heart rhythm
a pt. receiving instructions for warfarin therapy asks the nurse about what medications she can take for headaches. the nurse shoul tell her to avoid which type of medication? NSAIDs
the nurse is teaching a pt. about self-administration of lovenox. which statement should be included in this teaching session? "this drug is given in the folds of the abdomen, but at least 2 in. away from your navel"
a pt is receiving heparin therapy as part of the treatment for a PE. the nurse monitors the results of which lab test to check the drug's effectiveness? aPTT
a pt has received a double dose of heparin in surgery and is bleeding through the incision site. the nurse should prepare to take what action at this time? give IV protamine sulfate as an antidote
a pt is starting warfarin (coumadin) therapy as part of the treatment for A fib. The nurse will follow which principles of warfarin therapy? -administer the oral dose at the same time everyday -assess carefully for excessive bruising or unusual bleeding -monitor labs for a target INR of 2.0-3.0
Created by: lissy11