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pharm test 4
ch. 27 coagulation modifier agents
| Question | Answer |
|---|---|
| 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
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