Coagulation Modifier Drugs

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Author:
Fyrcracker
ID:
246882
Filename:
Coagulation Modifier Drugs
Updated:
2013-11-14 12:05:01
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Anticoagulants Antiplatelets Thrombolytics
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Description:
PP pg 5-9
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  1. Name the Coagulation Modifier Drugs.
    • Anticoagulants
    • Antiplatelets
    • Thrombolytics
  2. What is the action of Anticoagulants?
    • Inhibit the action/formation of clotting factors
    • Prevent clot formation
  3. What is the action of Antiplatelet drugs?
    • Inhibit platelet aggregation
    • Prevent platelet plugs
  4. What is the action of Thrombolytic drugs?
    Lyse (break down) existing clots
  5. What is Hemostasis?
    The process that halts bleeding after injury to a blood vessel
  6. Why would a client be prescribed an Anticoagulant?
    • for prophylactic Tx: prevent Thrombus (clot formation)
    • prevent embolus (dislodged clot)
  7. How does Heparin & LMWH work?
    Prevent clot formation by turning off coagulation pathway.
  8. How does Warfarin work as an Anticoagulant?
    Inhibiting Vitamin K synthesis by bacteria in intestinal tract -> inhibits clotting factors.
  9. Due to the Anticoagulants ability to prevent clot formation it helps prevent what health conditions?
    • Stroke
    • MI (myocardial infarction)
    • DVT (deep vein thrombosis)
    • PE (pulmonary embolism)
  10. What should a client starting on Warfarin be taught to watch for with this drug?
    Bleeding
  11. What are the Anticoagulant drugs?
    • Heparin
    • Low-molecular-weight heparin
    • Coumadin 
    • Arixtra
  12. What is the antidote for Heparin?
    protamine sulfate
  13. What is the antidote for Warfarin?
    Vitamin K
  14. What lab tests are used to monitor Heparin?
    Activated Partial Thromboplastin Time (aPTT)
  15. What are the names of the two LMWH drugs?
    Lovenox & Fragmin
  16. LMWH like Lovenox don't require frequent lab tests like regular Heparin.  But what test is used to monitor Lovenox?
    aPTT & PLATELET COUNT
  17. What is the critical assessment for administration of Heparin?
    aPTT, platelet count
  18. What labs are monitored when a client is taking Warfarin?
    PT & INR
  19. What is the normal INR range for a client NOT taking Warfarin?
    INR of 1.0
  20. What is the Therapeutic IRN range for a client on Warfarin?
    INR of 2-3.5 (depending on indication)
  21. Warfarin has a long duration of action and half-life.  What are they?
    • Duration of action: 2-5 days
    • Half-life: 1/2-3days
  22. Can a client on Heparin start taking Warfarin as well?
    Yes, until PT-INR levels indicate adequate anticoagulation.
  23. What should a client taking an Anticoagulant be taught?
    • Labs are important!!
    • s/s of abnormal bleeding
    • measures to prevent bruising, bleeding, or tissue injury
    • Medic alert bracelet
    • Avoid: foods ^in Vit K (tomatoes, greens)
  24. Which drugs have Antiplatelet properties?
    • Aspirin
    • Persantine
    • Plavix & Ticlid
    • Aggrastat & Itegrilin
  25. What are the a/e with Antiplatelet drugs?
    ASA: bleeding, heartburn, <platelets
  26. What is the purpose of using Antiplatelet drugs?
    reduce risk of fatal & nonfatal strokes
  27. What are the patients taught when started on an Antiplatelet drug?
    • Monitor for abnormal bleeding
    • drug-drug interactions
    • medic alert bracelet
    • LABS
  28. Name the Thrombolytic drugs.
    Streptase, t-PA, Activase, Eminase, Retavase, TNKase, Xigris
  29. What is the mechanism of action for the Thrombolytic drugs?
    • Activate the fibrinolytic system to break down the clot in the blood vessel quickly.
    • Activate plasminogen & convert it to plasmin, which can digest fibrin.
  30. What is the reason for prescribing a client a Thrombolytic drug?
    • Reestablish blood flow to the heart muscle via coronary arteries, preventing tissue destruction.
    • Acute MI, Arterial thrombolysis, DVT, Occlusion of shunts or catheters, PE, Acute ischemic stroke.
  31. What are the A/E of Thrombolytic drugs?
    • Bleeding: internal, intracranial, superficial
    • Other: N/V, hypotension, anaphylactic, cardiac dysrhythmias
  32. What are the nursing implications in general for the Coagulation Modifier Drug goups?
    • Monitor for therapeutic effects
    • s/s of bleeding
    • ^BP, HA, hematoma formation, hemorrhage, SOB, chills, fever
  33. What are Antilipemic drugs used for?
    to lower lipid levels
  34. Name the drugs in the Antilipemic group HMG-Coa Reductase Inhibitors (HMGs, or Statins).
    Lovastatin, pravastatin, simvastatin, atrovastatin
  35. What is the mechanism of action with the HMG-CoA Reductase Inhibitor drugs?
    • Inhibit HMG-CoA reductase, which is used by the liver to produce cholesterol.
    • Lower the rate of cholesterol production
  36. What are the A/E of the HMG-CoA Reductase Inhibitors?
    • mild, transient GI disturbances
    • rash
    • HA
    • Myopathy (muscle pain), possibly leading to the serious condition Rhabomylosis
    • elevations in liver enzymes or liver disease
  37. What are the nursing implications for Antilipemics?
    • Obtain baseline liver fxn tests
    • Assess dietary patterns, exercise, Wt, Ht, VS, tobacco, & alcohol, Family Hx
  38. What are special things are taught to a client taking Niacin?
    • Started on a LOW dose initially & gradually increased & take w/meals to minimize A/E
    • Small doses of ASA or NSAIDs can be taken 30min before niacin to <cutaneous flushing
  39. What are the general nursing implications with Antilipemics?
    • instruct pts to report persistan GI upset, constipation, abnormal bleeding, yellow skin
    • Monitor: A/E, liver enzyme tests
    • Monitor for therapeutic effects
    •     *<cholesterol & triglyceride levels

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