Term
|
Definition
Promotes thrombus formation under 3 conditions:
1.) Endothelial Injury
2.) Sluggish Blood Flow
3.) Increased Coagulopathy |
|
|
Term
| What is the process of Virchow's Triad? |
|
Definition
-Vessel wall is injured
-Attracts platelets
-Inflammatory process
-Clot formation is stimulated
-Stagnant blood flow = platelets and clotting factors adhere to the vessel wall
-Leads to thrombus formation which can occlude the blood vessel and cause am emboli to develop. |
|
|
Term
|
Definition
| Occurs when a portion of all of the thrombus breaks loose and travels through the circulatory system and embeds in a smaller vessel |
|
|
Term
| What are the 2 types of emboli? |
|
Definition
|
|
Term
| What is an arterial emboli? |
|
Definition
Originate in the left side of heart and travel to organs
Brain, Heart- cause an infarction |
|
|
Term
|
Definition
Originate in the venous circulation and travel to the right side of the heart, then to the pulmonary circulation
Deep Vein thrombosis
Pulmonary Emboli |
|
|
Term
| What are the preventative measures one can take for embolus/thrombus? |
|
Definition
Increasing Mobility
Hydration
Anti-embolism hose
Sequential compression devices
Anti-platelet agents
Anti-coagulants |
|
|
Term
| What are the interventions for an ACTIVE thrombus/embolus? |
|
Definition
AVOID PREVENTION STRATEGIES!
THESE ACTIONS COULD DISLODGE THE CLOT
Treat with thrombolytic agents or embolectomy |
|
|
Term
| What do anticoagulants do? |
|
Definition
|
|
Term
| What do antiplatelets do? |
|
Definition
| Prevent platelet aggregation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| formation of a clot or thrombus in an arterial or venous vessel. |
|
|
Term
|
Definition
| Thrombus moving through the blood stream. |
|
|
Term
|
Definition
| purplish or bright red hemorrhagic spots |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Heparin binds with antithrombin III to inactivate Thrombin which then inhibits the conversion of fibrinogen to fibrin which prevents a clot from being formed |
|
|
Term
| What is the half life of heparin sodium? |
|
Definition
|
|
Term
| HOw is heparin given? (Lipo-Heprin) |
|
Definition
| Usually given sub-Q or IV (bolus or continuous infusion) |
|
|
Term
| What is heparin used for? (Lipo-Heprin) |
|
Definition
Rapid anticoagulation effect for:
Pulmonary Embolism (PE)
Deep Vein Thrombosis (DVT)
Evolving Stroke
Open heart surgery
Disseminated intravascular coagulation (DIC)
Prevent venous thrombosis from leading to PE and DVT |
|
|
Term
| What does heparin actually DO? (Lipo-Heprin) |
|
Definition
|
|
Term
| WHo should not use heparin? (Lipo-Heprin) |
|
Definition
| Contraindications: stroke, peptic ulcer, blood anomalies |
|
|
Term
| What is used as an antedote for heparin? (Lipo-Heprin) |
|
Definition
| Protamine sulfate SLOW IV push |
|
|
Term
| What labs are important for heparin? (Lipo-Heprin) |
|
Definition
PTT - Want 1.5-2.5 x 60-70 seconds
aPTT - Want 1.5-2.5 x 30-40 seconds |
|
|
Term
| What is the purpose of low-molecular weight Heparin? |
|
Definition
| More stable responses at recommended doses |
|
|
Term
| What are 2 examples to low-molecular weight Heparin? |
|
Definition
Enoxaparin Sodium (Lovenox)
Dalteparin sodium (Fragmin) |
|
|
Term
| Are labs needed with low-molecular weight Heparin? |
|
Definition
|
|
Term
| What is low-molecular weight Heparin prescribed for? |
|
Definition
| Preventions of PE and DVT after abdominal/orthopedic surgery |
|
|
Term
| What is the frequency of administration of l-m heparin? |
|
Definition
| Given 1-2 times daily SUBQ |
|
|
Term
| Is the half-life of lmw heparin longer or shorter than Lipo-Heparin? |
|
Definition
|
|
Term
| What are some other ANTICOAGULANTS like Heparin? |
|
Definition
Rivaroxaban (Xarelto)
Apixaban (Eliquis)
Dabigatran etexilate (Pradaxa)
Argatroban |
|
|
Term
| What are direct thrombin inhibitors: parenteral anticoagulants II? |
|
Definition
| There are only 4. They inhibit thrombin DIRECTLY. |
|
|
Term
| What are the 3 direct thrombin inhibitors given IV? |
|
Definition
Argatroban (Acova)
Bivalirubin (Angiomax)
Lepirudin (Refludan |
|
|
Term
| What is the only direct thrombin inhibitor given subQ? |
|
Definition
|
|
Term
| Why will you not see direct thrombin inhibitors very often? |
|
Definition
| MORE EXPENSIVE THAN OTHER OPTIONS! |
|
|
Term
| What is an oral anticoagulant? |
|
Definition
|
|
Term
|
Definition
| inhibits hepatic synthesis of Vit.K+ which affects blood clotting |
|
|
Term
| What is the half-life of Warfarin? |
|
Definition
|
|
Term
| What are the herbal interactions with coumadin? |
|
Definition
| Garlic, Ginger and Ginkgo Increase actions of anticoagulants |
|
|
Term
| What are the side effects of Warfarin? |
|
Definition
| BLEEDING (petechiae, ecchymosis, hematemesis, hematuria) |
|
|
Term
| Oral coagulants are an __________ to Vitamin K. |
|
Definition
|
|
Term
| What is the anecdote for coumadin? |
|
Definition
|
|
Term
| What should be given if Vitamin K doesn't work for Warfarin overdose? |
|
Definition
| Fresh-frozen plasma or platelets |
|
|
Term
| What labs are important to note when given Warfarin/Coumadin? |
|
Definition
|
|
Term
| What is the normal INR range? |
|
Definition
|
|
Term
| What is the desired range for INR for patients on Coumadin? |
|
Definition
|
|
Term
| How are ANTIPLATELETS used as a prophylactic treatment? |
|
Definition
|
|
Term
| How do ANTIPLATELETS work? |
|
Definition
| Suppress platelet aggregation |
|
|
Term
| What are the ANTIPLATELET drugs? |
|
Definition
Clopidogrel (Plavix)
ticlopidine (Ticlid)
dipyridamole (Persantine)
ASA (aspirin) also works |
|
|
Term
| What are the herbal interactions with anti platelets? |
|
Definition
| Garlic and Ginkgo increase affects of antiplatelets |
|
|
Term
| What is a thromboembolism? |
|
Definition
| occlusion of artery or vein by a thrombus or embolus (clot) |
|
|
Term
| What does a thromboembolism cause? |
|
Definition
| ischemia (decreased blood flow) and results in necrosis of the tissue |
|
|
Term
| What do clots to the heart cause |
|
Definition
|
|
Term
| What do clots to the lung cause? |
|
Definition
|
|
Term
| What do clots to the brain cause? |
|
Definition
|
|
Term
| What do clot to the legs cause? |
|
Definition
| deep vein thrombosis which if dislodged could cause all the above. |
|
|
Term
|
Definition
|
|
Term
| How do thrombolytics destroy clots? |
|
Definition
| Destroys the fibrin within the clot by converting plasminogen to plasmin which degrades fibrin and clotting factors |
|
|
Term
| What are the thrombolytic drugs? |
|
Definition
Alteplase (t-PA)
Reteplase (Retavase)
Streptokinase (Strepase, Kabikinase)- oldest version |
|
|
Term
| What are the adverse effects of thrombolytics |
|
Definition
| hemorrhage, vascular collapse |
|
|
Term
| What is the antidote for a thrombolytic? |
|
Definition
|
|
Term
PQ had a major stroke. Following his stroke
he was prescribed aspirin 81 mg and
clopidogrel (Plavix). Classification of
clopidogrel is: |
|
Definition
|
|
Term
PQ arrived in the emergency department 2
hours following his stroke. He was given an
intravenous (IV) injection of Alteplase. This
drug is a(n): |
|
Definition
|
|
