Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
hematologic drugs
| Question | Answer |
|---|---|
| what do anticoagulants do? | prevents clotting of blood, but does not break clots down |
| what conditions would you use anticoagulants for? | prevention of venous thrombosis, pulmonary embolism,prostetic heart valve paptients, prevention of recurrent MI and ischemic attacks,cerebrovascular accident, adjunct therapy during heart surgery/procedures, postoperative, acute MI, unstable angina. |
| what are the general side effects of aticoagulants? | hemorrhage is the general side effect but there are more to add to specific drugs |
| what are common drugs that the patient should not take while taking anticoagulants? | NSAIDS-ASPRIN!! |
| name the two commonly used anticoagulants: | factor Xa/thrombin inhibitors: heprin, Xa inhibitor: enoxaparin/Lovenox, warfarin/Cumadin |
| what are the side effects of heprin/Lovenox? | Hemorrhage, thrombocytopenia(low platelett count), Hypersensitivity reaction, Neurological injury from hemotoma formation during lumbar puncture/epidural anesthesia |
| what drug reverses the action of heprin? | Protamine reverses heprin activity |
| what should the nurse monitor while a patient is taking heprin? | vitals, aPTT should be no higher than 2X the baseline value, monitor platelet count stop if <100,000 use lepirudin instead, administer test dose firstmonitor spinal site fro hemotoma |
| list patient instructions for using heprin: | report bruising, hematomas, black tarry stools, calf pain, SOB, rash, itching |
| what are specific drug interactions for a patient taking heprin? | NSAIDS (ASPRIN!) antiplatelet drugs increase blleeding risk, IV nitroglycerin, some herbals |
| precaution is advised for patients with what conditions when taking heprin? | peptic ulcer disease, hemophiliea, severe hypertension, hepatic/renal disease, dissecting aneurysm |
| what are the specific side effects of warfarin/Coumadin? | hemorrhage, toxicity |
| what are the interventions used/applied to a patient taking warfarin? | monitor vitals, watching fro hypotension, tachycardia, check hematocrit level, for overdose stop taking, administer vitamin K parenterally/IV. if vit. k does not reverse toxicity administer frozen plasma or whole blood |
| what are other drugs that interact if taken with heprin? | ASPRIN, TYLENOL, glucocorticoids, sulfonomides, cephelosporins, phenobarbitol, Dilantin, Tegretol, of course vitamin K, excessive food w vit. K, many OTC and herbal meds. |
| name the most common anticoagulants: | warfarin/Coumadin, heprin, enoxaparin/Lovenox |
| name the three classifications of drugs that prevent or dissolve thrombi: | anticoagulants, antiplatelets,thrombolitics |
| what are thrombolitics? | thrombolytics break down thrombi that have already developed |
| Thrombolytics are used to treat what conditions? | acute MI, deep vain thrombosis, massive pulmonary emboli, ischemic cerebrovascular accidents, in occluded IV |
| The thrombolytic prototype drug is called what? | alteplase (Activase) |
| thrombolytic drugs use what suffix? | -ase |
| what are the side effects of the thrombolytic alteplase/Activase? | bleeding |
| what is the route given for the thrombolytic alteplase/Activase? | IV |
| what is tghe timing for giving alteplase for best therapeutic effect of MI? | 4 to 6 hours of the the onset of symptoms |
| what will the nurse monitor when gining alteplase to a patient? | Hgb, Hct, aPTT, PT, INR and fibrinogen levels, vitals, ensure iv access for emergency drugs. |
| for severe bleeding while taking alteplase the nurse should administer what drug? | aminocaproic acid (Amicar) and give blood products |
| patient should report what symptoms when taking alteplase? | prolonged bleeding, headache, unilateral weakness |
| what are the four types of anteplatelet drugs? | salicylics, ADP inhibitors, glycoprotein inhibitors, arterial vasodilators |
| salicylics do what? | inhibit platelet aggregation, reduce MI, angina, ischemic cerebrovascular incident, prevents occlusion od coronary stents |
| what is the prototype drug used for salicylics? | asprin (Ecotrin) |
| aprin prevents | vasoconstriction, platelet aggregation |
| how much is given to prevent cardivasular and cerebrovascular thrombi | 81 mg daily |
| what is the ADP inhibitor prototype drug? | Plavix/clopidogrel |
| what is the therapeutic effect of plavix/clopidogtrel? | reduced/inhibited platelet aggregation for risk reduction for MI, ischemic cerebrovascular accidents, ischemic attacks, coronary stents. |
| what are the side effects of PLavix? | gastric upset, bleeding, thrombocytopenia purpura |
| what precautions should be taken when giving plavix? | when pt. has GI bleed, liver/kidney dysfuncion, risk for bleeding |
| what drugs should be avoided while on plavix? | NSAIDS, glcocoricoids, alcohol, proton pump inhibitors, herbals |
| what pt. instructions should the nurse provide to a pt. taking plavix? | report prolonged bleeding, ^fluids for diarrhea, avoid alcohol, report GI bleed, sever sudden headache, easy bruising |
| contraindications for plavix use are? | peptic ulcers, bleeding disorders, thrombocytopenia, intracranial bleeding |
| give hematologic drug for what two types of anemia? | microcytic (iron deficiency) and megaloblastic (B12 dificiency) anemias |
| what prototype drug is given for iron deficiency microcytic anemia? | ferrous sulfate/ Feosol, iron dextran(INFed) |
| what are the side effects of Feosol? | nausea, constipation, heartburn, diarrhea, metallic taste, staining teeth, fatal iron toxicity |
| can Feosol be taken wityh food? | yes with reduced absorption |
| what patient instruction is important to relay to pt. regarding Feosol? | dark green black stools are expected, dilute liquid form w water, drink through straw |
| contraindications for Feosol are? | hemolitic anemia, sever liver disease, peptic ulcer, colitis |
| what is pernicious anemia? | lack of intrinsic factor |
| what is the protype drug used to treat pernicious anemia? | vitamin B12, cyanocoalamin (Nascobal, Cyanoject) |
| what routes may be used in administering vit. B12? | po,subq, IM, intranassaly |
| what administration interventions need to be done for vit b12? | confirm B12 gastric absorption ability using schilling test for po route, give w food, give intranasally ir parenterally if pos. gastric malabsorption, give 1 hr pc or ac, expect lifelong treatment, |
| what nursing intervention will be done when administering Vit. B12? | obtain B12 Hgb, Hct, RBC, reticulocyte count, monitor every 3-6 months, encourge diet high in B12 |
| what are the side effects of Vit B12 | diahrrhea, hypokalemia, |
| what other drugs intewract w Vit B12? | folic acid, chloramphenicol, alcohol, neomycin, VITAMIN C!!!!! |
| what drug is used for megaloblastic anemia? | folic acid (Folacin) |
| what are the therapeutic uses of folic acid? | folate deficiency (alcoholism), prevent neural tube defects in developing fetus, megaloblastic |
| what are the side effects of folic acid? | flushing |
| what are the contraindications of folic acid? | vit B12 deficiency, other types of anemia, neonates |
| what are interactions of folic acid? | folic acid may mask B12 deficiency, chloramphenicol, phynatoin/Dilantin |
| what are the three typess of drugs that treat hemophilia? | factor viii, factor ix, and Desmopressin |
| what are the therapeutic uses of desmopressin? | mild hemophilia A- controls trauma induced bleeding and maintains homeostasis during surgery |
| what are the side effects of desmopressin? | fluid retention, hyponatremia |
| the nurse should do what interventions for a pt. on desmopressin? | monitor fluid I&O, monitor serum sodium levels, |
| the patient on desmopressin should: | weigh self daily and report significant increaase and edema |
| what are the contraindications of desmopressin? | renal failure, nephrongenic diabetes insipidus, type II B von Willerrands disease(von Willerbrand factor allows for platlet plug formation, missing this allows for blleding disorder) |
| what route can I give desmopressin? | IV, and intranasally |
| what should the nurse look for for when administrering desmopressin IV? | do not use if discolered, or w particles, dilute in 0.9% sodium chloride, administer IV bolus slowly over 15-30 min |
| what is the prototype drug to treat hemophilia A? | plasma derived Hemofil-M and recombinate factor VIII Advate |
| what is the prototpye drug to treat hemophilia B? | plasma derived Alpha-Nine SD, and recombinate IX Benefix |
| how do you administer facter VIII and IX? | powdered form into solution in IV, slowly IV bolus 5-10 min, give regularly scheduled doses one to two times per week to prevent bleeding, |
| which is safe plasma derived or recombinate VIII/IX? | recombinate is safer..plasma derived can cause Cretzfeldt-Jakob disease((CJD) is a form of brain damage that leads to a rapid decrease of mental function and movement) |
| The nurse should inform the patient of what information regarding factor VIII and IX? | risk of hepititis and HIV are low, and to report rash, itching swelling of the air way..reaction to the drug, explain creutzfeldt disease/risk and have emergency equipment and epinepherine for allergic reaction |
| what are the side effects of factor VIII and IX? | allergic reaction, anaphylaxis, creutzfeldt-jakob disease, |
| what are other drug interactions expected if taken with factor VIII and IX? | Asprin, first generation Cox-1 and COX 2 inhibiting NSAIDS, |
| what are the three factors that support hematopoiesis? | erythropoietic growth factor,leukopoietic growth factor, thrombopoietic growth factor |
| what is the drug name for the erythropoietic growth factor? | epoetin alfa (Epogen, Procrit) |
| what is the therapeutic use of epoetin alfa/Epogen? | spports production of erythrocytes in chronic renal failure, preoperative anemia, chemotherapy, HIV therapy |
| what are the side effects of epoetin alfa/Epogen? | hypertension, cardiovascular and cerebrovascular events, (MI, heart failure..)malignancy progreassion |
| interventions the nurse would do in regards to epoietin/Epogen are: | do not give to cancer patient NOT receiving chemotherapy or radiation, or the cancer patients whose Hgb is above 10mg/dl, monitor tumor growth, give lowest sode possible, monitor blood pressure |
| can epoetin/Epogen be gin to an iron deficient anemic patient? | NO |
| are there currently and drugs that interact with EPOGEN? | NO |
| What is the drug name for leukopoietic growth factor? | filgrastim (Neupogen) |
| what are the side effects of filgrastim/Neupogen? | Leukocytosis, bone pain fever, splenomegaly |
| intsruct the paitient to report what symptom when taking filgrastim/ Neupogen? | report bone pain or fever, report abdominal pain |
| based on the side effects of Neupogen, what would the nurse look for/monitor? | CBC, lower or stop use if WBC is above 10,000, monitor bone pain, T, monitor spleen enlargement |
| what are the contraindications of Neupogen? | sensitivity to E.coli, acute respiratory distress, current chemo/radiation |
| Neupogen interacts with what other drug? | cytotoxic drugs |
| What is the drug name for the thrombopoietic growth factor? | oprevekin (interleukin-11, Neumega) |
| what are the therapeutic uses of oprelvekin/Neumega? | thrombocytopenia from myelosuppressive chemotherapy for nonmyeloid canceers |
| what are the side effect of opervelkin? | cardiac dysrhythmias, fluid retention, allergic reactions, conjunctival infection, blurred vision, papilledema |
| nursing interventions regarding oprelevkin are: | monitor vitals, fluid I&O, weight edema, dyspnea, monitor for allergic reaction, opthalmic manifestations |
| contraindications of oprelevikin are: | myeloablative chemotherapy |
| important administering techniques include what for oprelvekin? | subQ 4-6 hrs after chemotherapy, continue until platelets are 50,000 or > do not shake vial, use each vial only once, wait 2 days before chemo. |
Created by:
mabrlg6240
Popular Pharmacology sets