Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
35 Cards in this Set
- Front
- Back
Thrombolitic disease
|
the process of forming a blood clot or thrombus
Fragments of a thrombus can break off and circulate until trapped in a capillary, creating an embolus Clotting cascade is activated when a blood vessel is injured, or with increased viscosity |
|
Intrinsic clotting pathway
|
Is initiated by the blood coming in contact with exposed collagen in the blood vessel wall, i.e., material within the blood or blood vessel wall.
|
|
Extrinsic clotting pathway
|
Is initiated with material outside of or "extrinsic" to the blood.
|
|
Conditions that cause clots to form (Risk factors)
|
Immobilization with venous stasis
Surgery, trauma to lower limbs Heart failure, vasospasm Cancers of the lung, prostate, stomach, pancreas Pregnancy, oral contraceptives Diabetes Truck Drivers Bed Ridden |
|
Stasis prevention
|
leg exercises
wearing stockings leg elevation sequential compression devices - device that includes a wrap on your legs and is connected to a pump that squeezes so blood circulates back to the heart. |
|
Revascularization treatments
|
(treatments that reroute blood flow through vessels)
percutaneous coronary intervention - stent (metal tube creating opening of clogged vessel) coronary artery bypass graft - take a vessel from elswhere in the body and graft it on the coronary artery |
|
Drug Therapy Goals for Thromboembolic Diseases
|
Primary purpose is to prevent platelet aggregation or inhibit steps in the clotting cascade
|
|
4 types of thrombolitic treatments
|
Platelet inhibitors
Anticoagulants Glycoprotein IIb/IIIa inhibitors Thrombolytics |
|
Anticoagulation therapy treatment
|
Prevents new clot formation
Treats existing clots |
|
Thrombus interventions
|
Do not massage area that may have a clot. Clot can dislodge and go to brain or lungs
evaluate pulse color temperature of skin |
|
Coagulation tests (blood test)
|
PT (prothrombin time) - pt value will determine adjustment of coumadin.
aPTT (activated partial thromboplastin time) - aPTT value will determine the adjustment of Heparin. INR (international normalized ratio) Platelet counts |
|
PT (protrombin time) lab value
|
determine increase or decrease adjustment of coumadin medication
|
|
aPTT (activated partial thromboplastin time) lab value
|
Determines the increase or decrease adjustment of Heparin.
|
|
Aspirin - uses
|
antiplatelet therapy
reduces frequency of: TIA - transient ischemic attack - temporary stroke due to temporary lack of blood to the brain. Ischemia= lack of blood flow Reduces frequency of MI - Myocardio Infarction |
|
Aspirin - Actions
|
Inhibits platelet aggregation for the life of the platelet (stops clumping)
Prolongs bleeding time |
|
MI - Myocardio Infarction
|
heart attack
|
|
Plavix - uses
|
reduce risk of ADDITIONAL:
myocardial infarctions (MI) Strokes Vascular death (vessel death) may be used together with aspirin |
|
Plavix - actions
|
Inhibits/disrupts the ADP pathway (aggregation process) required for platelet aggregation
Prolongs bleeding time - person will bleed longer prolonged bleeding time is beneficial for patients with weak hearts so that the blood will not thicken due to weak contractions of the heart. Same applies to Aspirin |
|
lovenox (eoxaparin) - actions
|
Low molecular weight heparin (LMWH)
Less potential for hemorrhage longer duration of action Prevents coagulation cascade no antiplatelet activity does not affect PT or aPTT |
|
Lovenox - uses
|
prevent DVT (deep vein thrombosus) after hip, knee or abdominal surgery
Treat DVT along with coumadin Treatment of STEMI (ST elevation MI) Derived from pigs - should not be given to patients allergic to pork |
|
Heparin - action
|
natural substance extracted from gut of pigs and cows
inhibits clotting factors No fibrinolytic qualities (cannot bust a clot) |
|
Heparin - Uses
|
treats
DVT Pulmonoary embolisms peripheral arterial embolisms MI hemodialysis (filtering of blood by machine outside the body) PCI - percutaneous coronary interventions (stent placement) |
|
Heparin - administration points to remember
|
never give po
do not aspirate this drug can be given subq or IV |
|
Platelet inhibitors - common adverse effects
|
Abdominal distress
hypotension |
|
Platelet inhibitors - serious adverse effects
|
Serious adverse effects
Neutropenia agranulocytosis bleeding |
|
Anticoagulant - patient education
|
Diet and nutrition
Limit intake of leafy green vegetables Drink six to eight 8-ounce glasses of fluid daily Exercise and activity after surgery to prevent venous stasis Do not flex knees or place pressure under knees; avoid being motionless Medication regimen Dose and timing, common and serious adverse effects, drug interactions |
|
Anticoagulants - adverse effects
|
Common adverse effects
Hematoma formation, bleeding at injection site Serious adverse effects Bleeding, thrombocytopenia |
|
Anticoagulants - assessment for bleeding
|
Monitor to detect hemorrhage
Symptoms of internal bleeding Decreased blood pressure, increased pulse, cold clammy skin, faintness, disorientation Consider all areas of the body that could begin to bleed (visible and internal) Monitor laboratory values aPPT, platelets, hematocrit |
|
Drug Class: Glycoprotein IIb/IIIa Inhibitors - drugs
|
Drugs: abciximab (ReoPro), eptifibatide (Integrilin), tirofiban (Aggrastat)
|
|
Drug Class: Glycoprotein IIb/IIIa Inhibitors - Actions
|
Actions
Block receptors on platelets, preventing aggregation and clot formation |
|
Drug Class: Glycoprotein IIb/IIIa Inhibitors - Uses
|
Uses
Prevent clots forming from the debris often released during percutaneous coronary intervention (PCI) procedures |
|
Drug Class: Glycoprotein IIb/IIIa Inhibitors - Serious side effects
|
Serious adverse effects
Bleeding thrombocytopenia |
|
Fibrinolytic Agents - uses
|
Uses
Dissolve fibrin clots secondary to coronary artery occlusion (MI), pulmonary emboli, cerebral emboli, deep venous thrombosis |
|
Fibrinolytic Agents - actions
|
Actions
Stimulate the bodies own clot-dissolving mechanism, converting plasminogen to plasmin, which digests fibrin |
|
Fibrinolytic Agents - drugs
|
Drugs: streptokinase, alteplase (Activase), reteplase (Retavase), tenecteplase (TNKase)
|