pathopharm wk9

low RBC→

anemia

low WBC→

leukopenia

low platelets→

thrombocytopenia

venous thromboembolism

Pt with a-fib are given

anticoagulants

Blood thinners that are not harmful to baby during pregnancy

heparins

Suspect bleeding→ watch…

hemoglobin (HGB) & hematocrit (HCT)

After administering meds thru IV/IM, hold pressure for how long?

5 minutes

Risks for deep vein thrombosis (DVT)

1. immobile

2. smoking/nicotine use

3. pregnancy/hormonal contraception (estrogen→ huge risk)

Heparin does not dissolve the clot but rather

prevent it from getting bigger

thrombolytics

dissolve the clot

Labs to check before admin heparin

1. aPTT: how long it takes for blood to clot (sec.)

2. HGB, HCT

3. platelets

The term for heparin causing platelets to destroy themselves is

heparin-induced thrombocytopenia (HIT)

What lab would you assess for above?

Antidote for heparin

Protamine sulfate

d-dimer

a protein fragment that is released when blood clots break down

Unlike heparin, warfarin is taken (route)?

PO

Actions of warfarin vs. heparin

Warfarin education

1. Take at the same time everyday (routine)

2. Maintain vitamin K

Labs to check for warfarin

1. INR

The higher the labs,

the more anticoagulated they are

Heparin→ warfarin

-want warfarin to kick in before taking pt off heparin

-remain in therapeutic window to anticoagulant

Antidote for warfarin

vitamin K

Clopidogrel is a stronger version of

aspirin (antiplatelet)

Clopidogrel is safer than

warfarin

Labs to check for Clopidogrel

1. HGB, HCT

2. platelet count

3. risk HIT

Rivaroxaban & Dabigatran

1. they don’t have to go in for lab draws

2. anticoagulant

3. NEWER & SAFER

We want to prevent a-fib from

developing blood clots

Enoxaparin

type of heparin (diet)

prevent dvt

subq shot still can cause HIT

dont rub injection site (adipose tissue) bc =bruising

APTT (2)=

Heparin

APT (1)/INR=

Warfarin

Ataxia

loss of control of bodily movements

ex. stumbling while walking

Alteplase

drug used to dissolve dangerous blood clots in patients with conditions like heart attack (if they don’t have stent) and stroke.

Alteplase is dangerous because

it will dissolve every clot in your body

Contraindications of alteplase

1. Any recent recent traumas/surgery

2. less than 3h of stroke

3. high BP

Alteplase education

1. watch for worsening of stroke (hemorrhagic stroke from hitting head)

2. signs of bleeding

3. HGB, HCT labs

Types of Anemias

1. pernicious anemia

2. b12 deficiency

3. iron deficiency

4. megaloblastic

5. ckd

pernicious anemia

no intrinsic factor→ lead to b12 deficiency bc cannot absorb b12

b12 deficiency

not eating enough b12

b12 needed for

DNA synthesis for red blood cell formation

iron deficiency anemia

not eating enough iron

megaloblastic anemia

aka folic acid deficiency; big cell anemia= DNA issue

CKD anemia

only real patho; bp low→ kidneys not getting enough blood flow(baroreceptors)→ erythropoietin

Anemias overall

not enough blood cells

bone marrow found in

bone pain in head, lil in skull, sternum, back, coccyx, femurs, and humerus

bone pain while taking filgrastim bc

bone marrow is hyperstimulated; treat w tylenol.

avoid taking filgrastim if pt has

leukemia