Agents that act on the blood

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jaime.davenport
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240349
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Agents that act on the blood
Updated:
2013-10-13 14:30:48
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agents that act blood
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pharm midterm fall 2013
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  1. Anticoagulants
    drugs that prolong the bodys ability to form a thrombus (clot) at different points in the coagulation cycle.
  2. Intrinsic pathway and coagulation
    Caused from peripheral vascular damage
    coagulation inhibited by components entirely contained within the vasculature.
  3. Goal of anticoagulant therapy
    promote anticoagulation while minimizing hemorrhagic complications through careful monitoring.
  4. Heparin MOA

    TEST ????
    no effect on existing clots- prevents formation of new thrombi

    Binds with antithrombin III at two sites, first site has effect on factor x, and second site binding occurs at conversion of prothrombin to thrombin.   TEST ???
  5. Clotting factors have different half lives.
    Which has shortest?
    Longest?
    Factor VII - 6-9 hours

    Factor II and X- up to 72 hours
  6. What is gold standard for monitoring anticoagulant treatment
    INR
  7. Dosage of warfarin
    • long half life but narrow therapeutic window
    • begin at 2.5- 5 mg daily

    Range is 1-15 have to individualize dose
  8. Acceptable INR in DVT
    2.0-3.0
  9. INR prevention of recurrent thrombosis
    2.0-3.0
  10. INR with cardiac valve replacement
    tissue
    mechanical
    • tissue valve 2.0-3.0
    • Mechanical valve 2.5-3.5
  11. INR recurrent systemic embolism
    2.5-3.5
  12. MOA of aspirin (platelet aggregator)
    • inhibits cyclooxygenase in platelets and endothelial cells, preventing synthesis of thromboxane and prostacyclin.
    • -both are potent platelet aggregators and vasoconstrictors.
  13. Hold warfarin if INR is greater than
    5
  14. ASA is used prophylactically to

    TEST???
    decrease incidence of MI/deaths in men > 50 years old. Treat unstable angina, non Q-wave infarction, and acute MI or CV
  15. Monitoring of Warfarin
    • Recommended dose 5-10 mg
    • Decrease dose in elderly, usually in half
    • Monitor INR every 2-3 days until goal is reached, then weekly, then every 2 weeks, then finally monthly when stable dose and stable INR
  16. Warfarin pregnancy category
    x
  17. Heparin preg category
    C
  18. ASA preg category
    D
  19. Most common problem in patients on aspirin taking NSAIDs is
    GI Bleed

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