Spring 2011Mid Anti-Coag Patient Management

Front 1

Blood clot that forms in and obstructs a vessel or
forms in a heart chamber.

Back 1

Thrombus

Front 2

Undissolved material carried by blood and impacted in some part of the vascular system
Can be air
fat
thrombus
etc.

Back 2

Embolus

Front 3

Oral anticoagulants :time frame necessary for onset of action.

Back 3

3-5 days

Front 4

Most common adverse effect of oral anticoagulants.

Back 4

Bleeding

Front 5

Oral anticoagulants are contraindicated in

Back 5

Pregnancy

Front 6

Warfarin
&
Related Anticoagulants

are primarily used in the long term Tx of Pts
who have what condition:
3ct

Back 6

~DVT
~A-Fib
~Artificial Valves.

Nm Rx?

Hint 6

Warfarin
&
Related Anticoagulants

Front 7

The dosage of oral anticoagulants to be given is based on the patient's

Back 7

Prothrombin time (PT).

Front 8

For most indications
a lab INR # of __ to __ is recommended

Back 8

2 to 3

Front 9

The antidote for oral anticoagulants.

Back 9

Vitamin K

Rx Name?

Hint 9

Phytonadione
(Phyto)

Front 10

Inactivates clotting factors by potentiating the activity of an endogenous anticoagulant called antithrombin III which is the most powerful endogenous inhibitor of thrombin.

Back 10

Heparin

Front 11

Inactivates active factor X

Back 11

LMWH

Specific Rx Nm?

Hint 11

Enoxaparin

Front 12

Enoxaparin maximal effect occurs when?

Back 12

3-5 hours after injection

Front 13

Heparin Dosing
is generally determined by
monitoring what
Lab Test

Back 13

aPTT

Front 14

Heparin Half life

Back 14

90 min

Front 15

The dosage of heparin is generally determined by monitoring the aptt; dosage is considered adequate when the aptt is

Back 15

1.5 to 2 times normal

Front 16

LMWH
-Is as effective as Heparin for tx of (2 things)
and
-Preferred as Initial Tx because of (2 things)

Back 16

DVT
&
PE

-Predictable Pharmacokinetics
-No Monitoring.

What Rx

Hint 16

LMWH

Front 17

Most common adverse effects of parenteral anticoagulants.

Back 17

-Bleeding
-Thrombocytopenia
-Hyperkalemia

Side Effects for for what type of Rx-s

Hint 17

parenteral anticoagulants.

Front 18

Occurs in about 25% of patients treated with heparin
is caused by a direct interaction between heparin and platelets
leading to platelet aggregation

Back 18

Type I HIT


Pts Tx-ed w/ ________Rx

causes a direct interaction leading to ______ _______

Hint 18

patients treated with heparin
is caused by a direct interaction between heparin and platelets
leading to platelet aggregation

Front 19

~Much less common
but
more serious condition caused by:

-Immunoglobulin-mediated platelet inactivation
and
-has a high risk of thrombotic complications
and
-mortality.

Back 19

Type II HIT

Hint 19

-Immunoglobulin-mediated platelet inactivation
and
-has a high risk of thrombotic complications

Front 20

Indicated for treatment of:
-Acute thromboembolic disorders
including
-peripheral embolism
-pulmonary embolism
-venous thrombosis
-coagulopathies such as
-disseminated intravascular coagulation.

Back 20

Parenteral anticoagulants.

Front 21

Used prophylactically to prevent clotting in:
-arterial surgery
-heart surgery
-blood transfusions
-Renal dialysis
-Blood sample collection

Also used to prevent:
-Embolization of thrombi in Pt-s w acute Atrial Fibrillation.

Back 21

Parenteral Anticoagulants

Front 22

Used to prevent:
~Venous thromboembolism....
associated with:

-abdominal surgery
-knee
-hip replacements

~also are approved to prevent ischemic complications of
-unstable angina
or
-non-ST segment elevation MI.

Back 22

LMWH

Used to prevent:
7ct

Hint 22

~Venous thromboembolism....
associated with:

-abdominal surgery
-knee replacements
-hip replacements

~also are approved to prevent ischemic complications of
-unstable angina
or
-non-ST segment elevation MI.

Front 23

Antidote for heparin-induced bleeding.

Back 23

Protamine sulfate

Is the Antidote for?

Hint 23

Heparin-induced bleeding.

Front 24

1mg of protamine neutralizes approximately ???
Of heparin sulfate

Back 24

100 units


Name the formula:
_ mg ______ neutralizes ___units ______ ______

Hint 24

1mg Protamine neutralizes = 100 Units Heparin Sulfate

Front 25

Prevents all types of:

-Arterial thrombosis
-cardiac damage in MI
-strokes
-TIA

-Also Tx-s Chronic Limb Ischemia.

Back 25

ASA

Front 26

Alternative anti-platelet drugs to aspirin.

Back 26

Clopidogrel and ticlopidine

Front 27

Administered I.V. to degrade an existing thrombus

NM Class
Nm Rx (2ct)

Back 27

Fibrinolytic drugs

-Streptokinase
&
-Alteplase

to degrade an existing thrombus Administer by?

Hint 27

I.V.

Front 28

ST segment elevation MI
these drugs are the primary means of restoring coronary blood flow in hospitals w/o facilities for angioplasty.

Rx Class
2 Rx-s

Back 28

Fibrinolytic drugs

-Streptokinase
&
-Alteplase

Front 29

Protein obtained from streptococci

Back 29

Streptokinase


obtained from?

Hint 29

streptococci

Front 30

Recombinant forms of human tissue plasminogen activator (t-PA)

Back 30

Alteplase

Is what Type of Rx?

Hint 30

Recombinant forms of

Human Tissue Plasminogen Activator
(t-PA)

Front 31

Principal adverse effects of
-Fibrinolytic Rx-s

Back 31

-Hemorrhage
-Reperfusion Arrhythmias

~Streptokinase
can cause various
Hypersensitivity Reactions ie:

-Anaphylactic Shock

Hint 31

Principal adverse effects of
-Fibrinolytic Rx-s

Front 32

Advantages of tpa over streptokinase

Back 32

-Less Bleeding
-More Fibrin Specificity
-Less Allergic Reactions

Advantages of:?

Hint 32

~ tPA
over
- Streptokinase

tissue plasminogen activator (t-PA)