Term
| Name 4 drug classes for coagulation |
|
Definition
1. Anticoagulants
2. Antiplatelets
3. Thrombolytics
4. Hemostatics/Antifibrinolytics |
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|
Term
|
Definition
Increase bleeding time
Targets VEINS
Block aggregation
Don't affect viscosity |
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Term
| Anticoagulant side effects |
|
Definition
Bleed
Retroperitoneal hemorrhage (Lumbar pain, unilateral bulge) |
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|
Term
| Unfractionated Heparin (anticoag) |
|
Definition
aPTT
Common parenteral med
Liver- occurs naturally
NEVER IM, don't aspirate/massage |
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Term
| What reverses the effects of a Heparin OD? |
|
Definition
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|
Term
| Warfarin/Coumadin (anticoag) |
|
Definition
PT/INR- Daily at first
Common oral med |
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|
Term
| Warfarin/Coumadin administration |
|
Definition
Same time q day
No sudden diet change
Dont decrease Vit. K
Vit. K reverses- 6h |
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Term
| What increases Warfarin's effects? (8) |
|
Definition
Amnio
ASA
Tagamet
Dextran
abx
Ginseng
Garlic
Dilantin |
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Term
| What decreases Warfarin's effects? (2) |
|
Definition
|
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Term
| Transitioning from IV Heparin to PO Warfarin |
|
Definition
| Take together 2/3 days (HRF bleed!) |
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Term
|
Definition
Fragmin, Lovenox
Poorly absorbed in GI
Factor Xa |
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|
Term
|
Definition
SQ: Love handles, 1 h
IV: Immediate
IM: HRF bleed
Leave bubble, 3/8 in, 90 degrees
NO pork allergies! |
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Term
| Factor Xa inhibtors (anticoag) |
|
Definition
Arixtra
Prefilled SQ
CBC, Hemoccult
Contraindicated: <50 kg, renal, epidural (black box spin/ep hematoma) |
|
|
Term
Labs/Therapeutic ranges:
1. PT
2. aPTT
3. Xa
4. INR |
|
Definition
1. PT: (12-15); 1.5-2x normal
2. aPTT: (21-35); 1.5-2.5x normal
3. Xa: (0 u/mL); 0.4-1.1
4. INR: (2-3); 3-4.5 if valve probs |
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|
Term
|
Definition
Prevents aggregation, HRF bleed (>10 min)
Aspirin, Plavix, Repro/Integrelin |
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|
Term
|
Definition
OTC meds are bad!
Blocks thromboxane
Contraindicated w/ asthma
1 325 mg tab lasts 1 wk |
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|
Term
|
Definition
|
|
Term
|
Definition
Prevent emboli: Stroke, MI, A-fib, Mechanical valves
Prevent MI/stroke: Plaque ppl |
|
|
Term
| Repro, Integrelin (Antiplatelet) |
|
Definition
Glycoprotein
IV: Stroke, MI, PTCA
$$$ |
|
|
Term
|
Definition
-ase (and t-Pa)
Uses: MI, PE, CVA, DVT
Destroy fibrin |
|
|
Term
|
Definition
C CBC, HH
L Look for dysrhythmias
O Observe for bleed
T The VS monitored |
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Term
| Thrombolytic Contraindications (7) |
|
Definition
Cranial hemorrhage
Aneurysm
BAD HTN
W/in 14 days trauma/sx
MI w/in 3 mo
GI bleed w/in 21 days
Glucose <40 or >400 |
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|
Term
| Thombolytic Considerations |
|
Definition
Baseline coag tests and CBC
S/S Cerebral hemorrhage (LOC)
Can cause dysrhythmias if post-MI |
|
|
Term
|
Definition
Reconsitute, don't shake
Needs own line
Admin w/in 6h MI and 3h CVA
Repeat in 30 min
VS q15min/h, then q30 |
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|
Term
| (4) Hemostatics/Antifibrinolytics |
|
Definition
Amicar
Opposite of anticoags
Watch for S/S clots
Bradycardia, low BP
Myoglobinuria: Red/brown urine |
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