Ch 44 Anticoagulation, Antiplatelet, and Thrombolytic Drug Flashcards
hemostatsis
stage 1- formation of platelet plug (platelet aggregation)
stage 2- coagulation (intrinsic coagulation pathway, extrinsic coagulation pathway)
3 drug groups for thromboembolic disorders
- anticoagulations
- antiplatelets
- thrombolytics
anticoagulants
disrupt the coagulation cascade, thereby suppressing the production of fibrin
antiplatelets
inhibit platelet aggregation
thrombolytics
promote lysis of fibrin, causing dissolution of thrombi
anticoagulants mechanism of of action (2)
- inhibit synthesis of clotting factors
2. inhibit activity of clotting factors
heparin (unfractionated)
enhances antithrombin
rapid acting anticoagulant
by IV or subQ only
heparin (unfractionated) therapeutic uses
Preferred anticoagulant during pregnancy and when rapid anticoagulation is required Pulmonary embolism (PE) Stroke evolving Massive deep vein thrombosis (DVT) Open heart surgery Renal dialysis Low-dose therapy postoperatively Disseminated intravascular coagulation (DIC) Adjunct to thrombolytic therapy
heparin (unfractionated) adverse effects
hemorrhage
HIT
hypersensitivity reactions
heparin (unfractionated) contraindications
thrombocytopenia
uncontrollable bleeding
during and immediately after surgery of the eye, brain, or spinal cord
antidote for heparin (unfractionated) overdose
protamine sulfate
lab for heparin (unfractionated)
activated partial thromboplastin time (aPTT)
LMW heparin
heparin preparations composed of molecules that are shorter than those found in unfractionated heparin
LMW heparin therapeutic uses
Prevention of DVT after surgery (Including replacement of hip, knee) Treatment of established DVT Prevention of ischemic complications Patients with unstable (angina, non–Q-wave myocardial infarction (MI), and ST-elevation MI (STEMI) )
LMW heparin administration route
subcutaneous