drugs for coagulation disorders
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| steps for clot formation | vasoconstriction, formation of platelet plug, activation of clottoing/coagulation cascade, formation of a fibrin clot,
fibrinolysis (clot retraction and dissolution)
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| need these electrolytes for clotting | calcium and potassium
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| CHADS2 score | scale that scores who needs to be on anticoagulants (0=low risk, aspirin; 2=high risk, warfarin)
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| action of acticoagulants | inhibit clot formation (occurs at end of cascade)
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| action of heparin | Prolong coagulation time by enhancing the actions of anti-thrombin III
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| heparin antidote | PROTAMINE SULFATE
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| duration of heparin | 8-12 hours (onset is almost immediate)
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| monitoring heparin | monitor dosages by PT and PTT; Monitor platelets for HIT (heparin-induced thrombocytopenia)
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| low molecular weight heparin action | Prolong coagulation by interfering with active factor X (Derivative of standard heparin with lower risk of bleeding)
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| advantages of LMWH | More stable response than heparin; can be administered at home by family or self (subq-prefilled syringes); Less likely to cause bleeding or HIT; Longer duration (thus slower to be metabolized) and immediate onset
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| action of warfarin/Coumadin | Inhibit hepatic synthesis of Vitamin K thus affects clotting factors II, VII, IX, and X (pt. must have consistent intake of vitamin K in diet)
**High alert drug**
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| onset of warfarin | 3-5 days; usually use bridging therapy with LMWH until warfarin sets in
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| some DDI's for warfarin | ASA, Vitamin K, NSAID, sulfa, OTC, ginger, gingko, garlic, green tea, laxatives (esp metamucil)
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| action of anti-platelet mx's | increase bleeding time by suppressing platelet aggregation
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| uses of anti-platelet mx's | Prophylactic use: Prevent myocardial infarction or stroke,Prevent repeat AMI or CVA,Prevent a CVA in a patient with TIA
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| action of thrombolytics | “clot-busters”; quickly restore blood flow to the tissue served by the blocked vessel
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| oral anticoagulant | warfarin/Coumadin
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| ADP receptor blocker medication | clopidogrel/Plavix
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| action of clopidogrel/Plavix | alter the plasma membrane of platelets which makes them unable to receive signals required for them to aggregate
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| indications for Plavix | Prevention of thromboembolic events in patients with a recent history of MI, CVA, or peripheral artery disease. Used following coronary artery stents.
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| what drug classification is Plavix | anti-platelet
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| normal range for INR | 2-3
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