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15 Cards in this Set
- Front
- Back
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ANTICOAGULANTS THROMBOLYTICS
Antiplatelets • Inhibits ?• Use: 3 |
Antiplatelets
• Inhibits platelets from adhering to fibrin lattice • Use: TIA, cardiac prosthetic valve, post MI |
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ANTICOAGULANTS THROMBOLYTICS
Anticoagulants 3 |
• Prevents coagulation cascade
• Prevents progression of clot • Allow internal plasmin to dissolve clot |
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ANTICOAGULANTS THROMBOLYTICS
THROMBOLYTIC action |
• Dissolves Clot
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ANTICOAGULANTS THROMBOLYTICS
COAGULATION CASCADE 5 |
w Clotting factors activated
w Prothrombin converted to thrombin • Blocked by Antithrombin III w Fibrinogen converted to fibrin w Fibrin forms a lattice w Platelets bind to the lattice |
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ANTICOAGULANTS THROMBOLYTICS
Heparin 7 |
Heparin
w Activates Antithrombin III w Injectable administration only • Subcutaneous - prevent post operative clotting, or bed ridden patient clotting • Heparin flush • Constant infusion following bolus dose • Treatment of deep venous thrombosis, pulmonary embolism • Eventually may switch to warfarin |
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ANTICOAGULANTS THROMBOLYTICS
HEPARIN MONITORING 3 |
w Activated Partial Thromoboplastin Time
• 1 1/2 to 2 1/2 times control w Bleeding w No intramuscular injections |
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ANTICOAGULANTS THROMBOLYTICS
LOW MOLECULAR WEIGHT HEPARINS 4 |
w Less bleeding reactions
w Subcutaneous administration w Can be utilized for ambulatory care therapy w Example: • Enoxaparin (Lovenox®) • Dalteparin (Fragmin®) |
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ANTICOAGULANTS THROMBOLYTICS
HEPARIN ANTIDOTE 4 |
w Protamine Sulfate
• Binds excess heparin • 1mg binds 100 units of heparin • Excess protamine has anticoagulant properties |
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ANTICOAGULANTS THROMBOLYTICS
WARFARIN 5 |
w Decreases production of vitamin K dependent clotting factors in the liver
w High protein binding - leads to many drug interactions w Monitor Prothrombin Time • INR 2 to 3 w Effect of each dose is not seen for 3 days w Maintain consistent vitamin K diet |
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ANTICOAGULANTS THROMBOLYTICS
WARFARIN USE 5 |
w Continuation therapy of heparin therapy for approximately 6 months
• Deep Venous Thrombosis • Pulmonary Embolism w Cardiac Valve Replacement, Atrial fibrillation - life long therapy w CONTRAINDICATION - pregnancy |
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WARFARIN OVERDOSE ANTIDOTE
2 |
w Phytonadione (Vitamin K)
w Administer via subcutaneous route |
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THROMBOLYTIC AGENTS
w DIRECT ACTING 2 |
• Urokinase
• Alteplase |
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THROMBOLYTIC AGENTS
w INDIRECT ACTING 1 |
• Streptokinase
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DIRECT ACTING
2 |
w Urokinase -Utilized to open clotted catheters
w Alteplase - Use • Pulmonary Embolism • Myocardial Infarction • Stroke (clot) |
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INDIRECT ACTING
2 facts – Use? |
w Stimulates conversion of plaminogen to plasmin
w Streptokinase – Use • Pulmonary Embolism |
