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30 Cards in this Set
- Front
- Back
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Anticoagulants do two things: prevent formation of thrombus or.....
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inhibit the extension of existing thrombus
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Anticoagulants inhibit the action of one of the clotting factors, but they do not....
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exert a fibrinolytic effect on existing clots
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List the basic pharmacodynamic effects of Heparin
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1. Enhances inhibatory actions of antithrombin III on several clotting factors
2. Prevents fibrinogen to fibrin conversion 3. Prevents the formation of a stable fibrin clot 4. Prevents thrombus extension |
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Discuss route for Heparin
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Not orally b/c inactivated in stomach acid. It is given SC and IV
Not IM b/c muscle is very vascular and it would bleed (causing a hematoma) |
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What patients would not be a good fit with heparin?
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going into surgery
severe hypertension dissecting aneurysm hemophiliac peptic ulcer ulcerative colitis |
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Name some low molecular weight heparins
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Lovenox and Fragmin
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What is the route for LMW Heparins?
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only subcut
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What are the common uses for Heparin?
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prophylaxis and treatment of venous thrombosis and pulmonary embolism
during acute stages of MI |
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Which drug reacts faster, Heparin or Coumadin?
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heparin
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What is the route for Coumadin?
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oral
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What is the generic name for Coumadin?
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warfarin sodium
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What is the pharmacodynamic action of Coumadin?
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Interferes with synthesis of vitamin K dependent clotting factors in the liver
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What is the result of the action of Coumadin?
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Deters further extension of existing thrombi and prevents new clots from forming
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What does Coumadin NOT do?
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affect the platelets
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How long does the first dose of Coumadin take to work?
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12-24 hours
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What is a lab test that is done frequently for Coumadin?
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PT
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Dosage of Coumadin (warfarin) should be adjusted to achieve and maintain a prothrombin time of....
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1.5-2 times the normal
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Overdose of anticoagulants can be treated by...
or specifically a. Heparin b. Coumadin |
omitting one or more doses of the anticoagulant until the patient stops bleeding.
A. Protamine Sulfate (binds to the heparin to stop its anticoagulant ability B. Vitamin K |
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What are some uses of Coumadin?
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1. prophylaxic treatment of DVT or pulmonary embolism
2. a fib with embolization (that may cause blood clots) 3. coronary occlusion, cerebral transient ischemic attacks (strokes, heart attacks) 4.prophylactic in patients with heart valves |
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Name the 11 adverse effects of anticoagulants
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hematuria
tarry stools vaginal bleeding ab, flank or joint pain headache change in LOC hematoma or bruising vomiting blood bleeding from nose or gums weak rapid pulse rate hypotension |
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What is the antidote for heparin?
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protamine sulfate
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What is the antidote for coumadin?
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vitamin K
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What products do you avoid when a patient is on anticoagulants?
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aspirin
IM injections too many or too few vitamin K foods |
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What labs do you do before administering Heparin?
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coagulation tests, hemoglobin, hematocrit and Platelet counts
PTT is for heparin ****know ptt time of 25-35 seconds ****pops up on many tests |
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Remember, with Coumadin, you run a ________
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INR, with Heparin you don't b/c it doesn't really affect thrombin
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What are normal lab values for prothrombin time?
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11-15 seconds
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What are normal lab values for platelet count?
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150,000-450,000
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What are normal lab values for hematocrit?
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41-53% male
36-46% female |
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In general, the goal of anticoagulants is to maintain the PT prothrombin time of _________
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1.5 to 2.0 of the normal value normal value is 11-15
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What do you want the INR to be when you are on a anticoagulant?
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2-3 times the normal value
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