MA: Reduction in LDL cholesterol by increasing LDL receptors on hepatocytes. Increase VLDLs (Tryglicerides) levels in some pts. Prevents reabsorption of bile acids.
TU: Reduces LDL cholesterol ( in junction with low-cholesterol diet and excersice) Controls hyperglycemia in persons with diabetes.
interfere with clotting factors in the clotting cascade.
Therapy is primarily prophylactic.
Prevent formation of new clots and extension of clots already present.
They do not dissolve existing clots.
Widely used in thrombotic disorders.
there are 2 types: Parental and Oral.
Inhibit platelet aggregation.
Used to treat and prevent ischemic events.
Use to prevent clot formation.
Describe thromboembolitic (thrombolytic):
Degrade fibrin strands and used to help dissolve an existing clot.
use when MI.
What is heparin's MA? TU? AE? contraindications? antidote? labs?
MA: Enhances antithrombin Rapid-acting anticoaguant Administered by injection only (IV, or subQ)
TU: Preferred when pregnancy and when rapid anticoagulancy is required. PE (pulmonary embolism). Stroke evolving. Massive deep venous thrombosis (DVT) Open-heart surgery. Renal Dialysis. Low-dose therapy postoperatively. Adjunct to thrombolytic therapy.
Contraindications: Thrombocytopenia. Uncontrollable bleeding. During and immediately after surgery of the eye, brain, or spinal cord.
what is a parental anticoagulant drug?
what is a oral one?
Parental: Heparin and enoxaparin (low molecular weight)
What is enoxaparin advantages? TU? MA? AE? and antidote?
Advantages: Less lab monitoring needed. Less likely to cause thrombocytopenia. Half life longer — permits once daily dosing. Does not cross placeneta. DOC — port op. Composed of shorter molecules than heparin.
TU: Prevention of DVT following surgery. Treatment of established DVT. Prevention of ischemic complications in patients with unstable angina, non-Q wave MI, and STEMI.
MA: SubQ. Dosage based on body weight. Costs more than unfractionated heparin. Does not required monitoring; Can be given at home.
AE: Bleeding (but less than w heparin). Blacks stool. Dizziness. Immune-mediated thrombocytopenia. Severe neurologic injury for patients undergoing spinal puncture or spinal epidural anesthesia. Pruritis (itching)
Antidote: Protamine sulfate.
what are Warfarin's CU? TU? AE? DI? Labs? antidote?
CU: Oral anticoagulant with delayed onset. blocks the biosynthesis of factor VII, IX, X and prothombin.
TU: Not useful in emergencies. Long-term prophylaxis of thrombosis (PE, thromboembolism, thrombosis)
AE: Hemorrhage (vitamine K for toxicity). Fetal hemorrhage and teratogenesis from use during pregnancy. Use during lactation. Black stool.
DI: Heparin. Aspirin. Acetaminophen. Drugs that increase anticoagulant effects. drugs that promote bleeding. drugs that decrease anticoagulant effects.