Beruflich Dokumente
Kultur Dokumente
https://www.youtube.com/watch?feature=pla
yer_embedded&v=xNZEERMSeyM
Process of Coagulation
Hemorrhagic disorder
Anticoagulant Therapies
A. Antiplatelet
1. Aspirin
2. Thienopyridines
a. Fondaparinux (Arixtra)
5. Vitamin K Antagonists
(Warfarin, Coumadin)
C. Fibrinolytics
Actions of Anticoagulants
Antiplatelet
Anticoagulants
Thrombolytic drugs
Classification of
Cyclooxygenase Inhibitors
Drugs with anti-inflammatory properties
Acetaminophen
Antiplatelet Drugs
Aspirin (ASA)
Inhibition of cyclooxygenase
Ticlopidine (Ticlid)
ADP receptor antagonists
Tirofiban (Aggrastat)
GP IIb / IIIa receptor antagonists
Antiplatelets-Aspirin
Action
Aspirin
Nonselective inhibitor of cyclooxygenase
Therapeutic uses
Analgesic, antipyretic, anti-inflammatory
Suppression of platelet aggregation
Dysmenorrhea
Cancer prevention
Prevention of Alzheimers disease
Antiplatelet (cont.)
Contraindications
Allergy,
Caution
Reyes syndrome
Adverse effects
Bleeding
GI distress
Drug-to-drug interaction
Anticoagulants: warfarin and heparin
Glucocorticoids
Alcohol
Ibuprofen
ACE inhibitors and ARBs
Clopidogrel (Plavix)
Therapeutic uses
Prevents blockage of coronary artery stents
Reduces thrombotic events in patients with
acute coronary syndromes
Anticoagulants
Argatroban (Acova)
Bivalirudin (Angiomax)
Mechanism of action
Facilitates the actions of antithrombin
Prevents conversion of fibrinogen to fibrin
Prevents activation of factor XIII
Adverse effects
Bleeding
Back pain
Nausea, headache
Rivaroxaban
Binds directly with factor Xa to cause
inactivation
Oral
Rivaroxaban (Xarelto)
Oral anticoagulant approved in 2011
Does not require laboratory monitoring
Patients who received rivaroxaban were
found to be much less likely to experience
DVT, VTE, PE, or death
Anticoagulants
Warfarin (Coumadin)
Heparin (generic)
Anticoagulants
Action
Pharmacokinetics
Contraindications
Cautions
Anticoagulants (cont.)
Adverse effects
Bleeding
GI upset
Hepatic dysfunction
Alopecia, dermatitis, bone marrow suppression, and
prolonged and painful erection
Drug-to-drug interactions
Heparin
Rapid acting anticoagulant
Uses
Pulmonary embolism
Stroke
Vein thrombosis
Adverse Effects
Hemorrhage
Thrombocytopenia
Hypersensitivity reactions
Low-Molecular-Weight Heparins
Inhibit thrombus and clot formation by blocking factors Xa
and Iia
Do not greatly affect thrombin, clotting, or prothrombin times;
therefore, they cause fewer systemic adverse effects
Block angiogenesis, the process that allows cancer cells to
develop new blood vessels
Are indicated for specific uses in the prevention of clots and
emboli formation after certain surgeries or bed rest
Warfarin (Coumadin)
Oral anticoagulant
Antagonist Vitamin K
Effects synthesis - Factors VII, IX, X, and
prothrombin
Uses
Adverse Effects
Hemorrhage
Coumadin(Warfarin)
https://www.youtube.com/watch?featur
e=player_embedded&v=ucP1OEOGO5E
Patient education video for monitoring and
taking Coumadin.
Thrombolytic Drugs
Streptokinase
Binds plasminogen
Uses
Myocardial infarction
Deep vein thrombosis
Massive pulmonary emboli
Adverse Effects
Bleeding
Hypotension
Fever
Thrombolytic Therapy
Action to dissolve clots
Thrombolytics
Alteplase -Tissue plasminogen activator
Reteplase
Streptokinase
Urokinase
Anistreplase
Thrombolytic Agents
Action
Activate plasminogen to plasmin, which in turn breaks down fibrin
threads in a clot to dissolve a formed clot
Indications
Acute MI, pulmonary emboli, and ischemic stroke
Pharmacokinetics
Drugs must be injected and are cleared from the body after liver
metabolism
Contraindications
Allergy
Streptokinase (Streptase)
Binds to plasminogen to form active complex
Therapeutic uses
Adverse effects
Thrombolytic Drugs
Streptokinase (Streptase); Alteplase (tPa)
Major adverse effect bleeding (minor
oozing to life-threatening amount)
Bleeding
Cardiac arrhythmias
Hypotension
Hypersensitivity: rash, flushing, bronchospasm, and
anaphylactic reaction
Drug-to-drug interactions
Anticoagulants
Antiplatelet
Liver disease
Antihemophilics
Actions
Indications
Pharmacokinetics
Antihemophilics (cont.)
Contraindications
Allergy
Lactation
Caution
Pregnancy
Adverse effects
Indication
Pharmacokinetics
Allergy
Acute DIC
Caution
Excessive clotting
Drug-to-drug interactions
Heparin
Causes
Blood loss
Hemolysis
Bone marrow dysfunction
Lacks hemoglobin
Stage 2 Erythroblasts
Gains hemoglobin
Stage 3 Reticulocytes
Immature erythrocytes
Stage 4 - Erythrocytes
Maturity
Iron Preparations
Ferrous Sulfate
Indications
Administration
Drug Interactions
Adverse Effects
GI disturbances
Staining of teeth
Toxicity
(100-
Consequences
Megaloblastic anemia
Neurologic damage
GI disturbances
diet
Malabsorption syndrome
Consequences
Megaloblastic
anemia
Neural tube defects
Uses
Chronic renal failure
HIV-infected patients
Chemotherapy
Adverse Effects
Hypertension
Filgrastim (Neupogen)
Filgrastim
Hematopoietic growth factor
Recombinant DNA technology
Uses
Chemotherapy
Bone marrow transplant
Chronic neutropenia
Adverse Effects
Bone pain
Uses
Chemotherapy
Adverse Effects
Fluid Retention
Cardiac Dysrhythmias