Hematopoietic Drugs Exam 3
- Medical College of Georgia
- Nursing 6200
- Hematopoietic Drugs Exam 3
Last Modified: 2011-07-07
Related Textbooks:Nutrition & Diet Therapy: Evidence-Based Applications
Related Textbooks:Pharmacology for Nursing Care, 7th Edition (Book & CD-ROM)
Antiplatelets, anticoagulants, thrombolytics
- Cyclooxygenase inhibitor - Aspirin
- Adenosine diphosphate receptor antagonists - ticlopine (Ticlid), Clopidogrel (Plavix)
- Glycoprotein IIb-IIIa receptor antagonists – abciximab (Reopro)
- Factor V and thrombin inhibitor - Heparin...
- Vitamin K antagonist - Warfarin (Coumadin)
- Direct Thrombin inhibitors – Argatroban (Acova)
- Vessel Spasm
- Formation of the Platelet Plug
- Blood Coagulation
- Clot Retraction
- Clot Lysis
blood clot within a vessel or the heart
Arterial - begin w/ formation of a platelet plug, which is reinforced w/ fibrin
Venous - begin with fibrin, & enmesh RBC & platelets
Prevention and treatment of thromboembolic disorders.
What is the primary complication of Heparin?
hemophiliacs, Von Willdebrand disorder
- Given when rapid onset of anticoagulation desired
- Heparin (Unfractionated)
- Given IV or SC, no oral absorption
- Decreases fibrin formation – by promoting...
- Plasma levels vary – monitor PTT
- Hepatic metabolism, renal excretion,
- Half life: 1.5 hrs (normal renal, liver function)
- Hemorrhage/bleeding is the principal...
- Protamine sulfate – antidote for too much heparin
- Enoxaprin (Lovenox), Dalteparin (Fragmin)
- Given SQ
- Given on a fixed dose schedule
- PTT monitoring not required
- Less likely to cause thrombocytopenia
- Can be used at home
- Adverse effects - bleeding
- Argatroban (Acova)
- Action: direct inhibition of thrombin
- IV – 2mcg/kg/min, if liver prob. 0.5 mcg/kg/min
- Pharmacokinetics – short half-life (45 min), liver metabolism
- Treatment alternative for patients with HIT
- Adverse effects: bleeding, allergic reactions (dyspnea, cough, rash)
- General use: prevention of thrombosis
- Actions: suppresses platelet aggregation and prolongs...
- Contraindications: hypersensitivity, ulcers, active...
- Precautions: any patient with a risk of bleeding.
- Interactions: concurrent use with NSAIDs, heparin,...
- Adenosine Diphosphate Receptor Antagonists- Ticlopine...
- Glycoprotein IIb/IIIa Receptor Antagonists –
- Inhibition of cyclooxygenase
- > thromboxane A can’t be synthesized...
- Adenosine Diphosphate Receptor Antagonists
- Inhibits platelet aggregation by...
- Ticlopine (Ticlid)
- Indicated to prevent ischemic stroke.
- Can cause life threatening hematologic reactions.
- Clopidogrel (Plavix)
- secondary prevention of ischemic stroke, MI,...
- Adverse events about the same as ASA.
- 81 to 325 mg per day.
- SE: bleeding problems, and anaphylaxis
- “ Super aspirins”
- most effective antiplatelet therapy.
- Blockage of platelet receptors to inhibit the final step in aggregation.
- Can block aggregation from any path.
- Used short-term to prevent ischemic events.
- May be given with heparin and ASA therapy.
- Bleeding is the primary adverse event.
- Protein extracted from streptococci cultures.
- Given to remove thrombi that have formed.
- Prototype thrombolytic drug.
- Indicated in acute MI, DVT, massive PE.
- Adverse effects
- Bleeding is major complication
- Produced by recombinant DNA technology
- Indicated in MI (slightly better than streptokinase), pulmonary embolus, acute ischemic stroke
- $$$$$ 7 to 8 x steptokinase
- Adverse effects
- GUSTO – global utilization of streptokinase and tPA for occluded coronary arteries
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