Ch 37 Anticoagulant & Thrombolytic Drugs
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| Anticoagulants Actions | Interfere with the clotting mechanism of the blood
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| Anticoagulant Uses | `Prophylaxis and treatment of DVT
`P&T of a.fib w/ embolization
`P&T of PE
`Adjuvant tx of MI
`Prevention of thrombus formation after valve replacement surgery
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| Parenteral Anticoagulants specifically used for | `Prevention of postoperative DVT and PE (major ab sx): of clotting in arterial and heart sx, in equip used for extracorporeal circulation, blood transfusions, and in blood samples for lab purposes: of cerebral thrombosis: DIC: IV patency
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| Anticoagulant Adverse Reactions | `Bleeding
`N,V,Ab cramp, D
`Alopecia
`Rash
`Hepatitis, jaundice, thrombocytopenia, blood dyscrasias
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| Anticoagulant Contraindications | `Known hypersensitivity
`active bleeding (except caused by DIC)
`hemorrhagic disease
`TB
`leukemia
`uncontrolled hypertension
`GI ulcers
`recent sx of eye/cns
`aneurysms
`severe renal/hepatic disease
`during lactation
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| LMWHs contraindications | patients with a hypersensitivity to pork products
alternative fondaparinux (Arixtra)
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| Anticoagulant Precautions | `fever
`heart failure
`diarrhea
`diabetes
`malignancy
`hypertension
`renal/hepatic disease
`psychoses
`depression
`pt udergoing spinal procedures
`women of childbearing age (contraceptive)
`pt with potential sire for bleeding or hemorrhage
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| Anticoagulant Herbal Considerations: Warfarin should not be combined with | `celery
`chamomile
`clove
`dong quai
`feverfew
`garlic
`ginger
`ginkgo biloba
`ginseng
`green tea
`onion
`passion flower
`red clover
`st johns wort
`turmeric
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| Antiplatelet Actions & Uses | `decreasing the platelets' ability to aggregate in the arterial system
`primarily used to treat patients at risk for acute coronary syndrome, MI, stroke, and intermittent claudication
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| ADP (adenosine diphosphate) receptor blocker action | alter the platelet cell membrane
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| Glycoprotein receptor blockers action | prevent enzyme production
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| Antiplatelet Adverse Reactions | `Heart palpitations
`Bleeding
`Dizziness Headache
`N, D, Constipation, dyspepsia
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| Antiplatelet Contraindications & Precautions | `Pregnant/Lactating
`known hypersensitivity
`CHF
`active bleeding
`thrombotic throbocytopenic purpura (TTP)
`Cautions in:older adult patients, pancytopenic patients, or renal/hepatic impaitment
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| Thrombolytic Actions | break down fibrin clots by converting plasminogen to plasmin
*potential benefits must be weighed carefully against the potential dangers of bleeding
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| Thrombolytic Uses | To Treat
`acute stroke or MI by lysis of blood clots in the coronary arteries
`blood clots causing pulmonary emoboli and DVT
`suspected occlusions in central venous catheters
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| Thrombolytic Adverse Reactions | Bleeding the most common
allergic reactions may also be seen
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| Thrombolytic Contraindications and Precautions | `known hypersensitivity
`active bleeding
`history of stoke, aneurysm, and recent intracranial surgery
Cautions in:
`recently undergone surgery 10 days
`experienced a stroke
`hypertension
`diabetic retinopathy
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