Pharm Exam 4: Clotting Meds

Factor VIII is classified as a…

antihemolytic factor

Factor VIII is used to treat…

hemophilia A

Factor VIII __________ the missing _____________ __________ (is a cofactor for factor ____)

replaces, clotting, Xa

What are 2 adverse effects of Factor VIII?

anaphylaxis, CJD

Factor VIII interacts with…

NSAIDS

Factor VII Nursing Implications

• give on __________ to stop bleeding

• multiple ______ may be needed to stop an ________ _______

• infusions are ___________ ____________ for prophylaxis

demand, vials, active bleed, regularly scheduled

What is the synthetic form of Factor VIII?

recombinant

Recombinant (synthetic form of Factor VII) must be…

refrigerated

Clopidogrel is classified as a…

antiplatelet drug

Clopidogrel (Plavix) is used to…(2)

• prevent ____________ of ___________ _________.

• reduce _______ for _____ and _______.

reocclusion, coronary stents, MI, stroke

Clopidogrel (Plavix) MOA

inhibits platelet aggregation

What are 3 side effects of Clopidogrel (Plavix)?

bleeding, GI ulcers, thrombocytopenia

What two things interact with Clopidogrel (Plavix)?

anticoagulants and several herbs

Ginger, Gingko Bilbo, Feverfew, and Primrose Oil ____________ _______________ of Clopidogrel (Plavix)

increase effectiveness

Taking Anticoagulants with Clopidogrel (Plavix) ____________ ______ of ______________.

increases risk, bleeding

Clopidogrel (Plavix) Nursing Implications

• monitor ____ and _____ of __________

• watch ________ count

S, S, bleeding, platelet

Take Clopidogrel (Plavix) with ______ or _______ to prevent GI upset

food, milk

Before giving Clopidogrel make sure pt doesn’t have _______________.

thrombocytopenia

What is the normal Platelet value range?

150,000-400,000

Enoxaparin is classified as a…

anticoagulant

Enoxaparin is used…

• as a _____________ for _______

• as a ______________ for _______ in ________ doses

prophylaxis, DVT, treatment, DVT, higher

Enoxaparin _________ ____________ on factor Xa and Thrombin.

inhibits antithrombin

The major side effect and contraindication of Enoxaparin is…

bleeding

What 2 drugs interact with Enoxaparin?

NSAIDS and antiplatelet drugs

Taking Enoxaparin with antiplatelet drugs will __________ ___________ _______

increase bleeding risk

Nursing Implications for Enoxaparin

• give ____ in the ________, it will likely _______

• don’t need to monitor any _____.

SQ, abdomen, sting, labs

Patient Education for Enoxaparin

• report signs and symptoms of ________

bleeding

Heparin is classified as a…

anticoagulant

Heparin works by ____________ __________ on factor _____ and __________.

inactivating antithrombin, Xa, thrombin

What are 2 side effects of Heparin?

thrombocytopenia and bleeding

What are 3 contraindications for Heparin?

thrombocytopenia, PUD, and bleeding

Which 2 drugs interact with heparin?

NSAIDS, antiplatelet drugs

When should you discontinue Heparin?

if platelet count is less than 100,000

Taking Heparin with anti-platelet drugs ___________ ___________ ______.

increases bleeding risk

Nursing Interventions for Heparin

• monitor _____ labs regularly

• Drug is given via IV for ______, and SQ for __________

aPTT, DVTs, prophylaxis

Patients on Heparin should report ____ and ____ of…

s,s,bleeding

What is a normal aPTT level?

30-40 seconds

What is a therapeutic aPTT level?

45-100 seconds

Salicylate/Aspirin is classified as a…

antiplatelet

What is the heparin overdose reversal drug?

protamine sulfate

Aspirin reduces risk for… (3)

MI, CVA, angina

Aspirin is an _______ that inhibits _______ and _______

NSAID, cox1, cox2

Aspirin inhibits platelet aggregation for life of platelet which is roughly ____-____ days

7,10

What are 3 side/adverse effects of Aspirin?

bleeding, reyes syndrome, tinnitus

4 contraindications for Aspirin

bleeding disorders, GI ulcers, kidney disease, anticoagulants

never give aspirin to…

children

For prophylactic use of Aspirin, it is dosed at _____mg

81

Therapeutic range of aPTT = _____-_____ x the normal range of aPTT

1.5, 2.5

Aspirin Patient Education

• monitor S and S of _____________

• take with ______ or ______

bleeding, food, milk

Warfarin is classified as a…

anticoagulant

Warfarin is used to…

• reduce the risk of _____, _____, and _______

• prophylactically treat __________.

MI, CVA, angina, bleeding

Warfarin ______ the action of vitamin ______ dependent ___________ _________ (VII, IX, X, and Prothrombin)

blocks, k, clotting factors

What is 1 side/adverse effect of Warfarin?

hemorrhage

Warfarin is contraindicated in patients with… (4)

bleeding disorders, thrombocytopenia, GI ulcers, low vitamin K levels

Warfarin Nursing Interventions

• monitor ______ lab values

• takes ___-___ days for full therapeutic effect

• antidote is __________ ____

INR, 3, 5, vitamin K

Lab value monitoring for Warfarin

• ______ is drawn at least _______ to monitor effectiveness.

• normal value is ____

• therapeutic range is ____-____

INR, monthly, 1, 3.5