NURS304 Module 4 Drugs/Prototypes

Heparin

• therapeutic class: Anticoagulant (parenteral)

• pharm class: Indirect Thrombin Inhibitor

• brand name: Hep-Lock

• primary use: To prevent thrombi from forming or enlarging, prevent the formation of clots in veins, treat thromboembolic disorders

• MOA: To inhibit specific clotting factors to prevent the formation or enlargement of clots

  • Works on the intrinsic pathway (parenteral/injected); short amount of time

• adverse side effects: abnormal bleeding

• The reversal agent is protamine sulfate

Coumadin

• therapeutic class: Anticoagulant (oral)

• pharm class: Vitamin K Antagonist

• brand name: Warfarin

• primary use: To prevent thrombi from forming or enlarging, prevent the formation of clots in veins, treat thromboembolic disorders

• MOA: To inhibit specific clotting factors to prevent the formation or enlargement of clots

  • Works on the extrinsic pathway (takes a while)

  • Inhibits the hepatic synthesis of factors II, VII, IX, & X

• adverse side effects: abnormal bleeding

• Reversal agent is Vitamin K

Apixaban

• therapeutic class: Anticoagulant (enteral)

• pharm class: Factor Xa Inhibitors

• brand name: Eliquis

• primary use: Prevention of deep vein thrombosis or pulmonary embolism

• MOA: Acts as a selective, reversible site inhibitor of factor Xa, inhibiting both free and bound factor; decreases thrombin generation

• adverse side effects: abnormal bleeding

Alteplase

• therapeutic class: Thrombolytic

• pharm class: Tissue plasminogen activator

• brand name: t-PA, activase

• primary use: To dissolve existing clots, to treat acute myocardial infarction, and deep vein thrombosis, and to clear IV catheters

• MOA: To convert plasminogen to plasmin, which digests fibrin and dissolves clot

• adverse side effects: bleeding internally or at puncture sites

Aminocaproic Acid

• therapeutic class: hemostatics

• pharm class: anti-fibrinolytic (fibrinolysis inhibitors)

• brand name: Amicar

• primary use: This is a drug used to prevent life-threatening hemorrhages

• MOA: To prevent fibrin from dissolving

  • Helps the patient clot by preventing fibrin from dissolving

• adverse side effects: skin reactions, headaches, thrombosis, and anaphylaxis

Aspirin

• therapeutic class: Antiplatelet agents, antipyretics, nonopioid analgesics

• pharm class: Salicylates; NSAIDS

• brand name: Bayer Aspirin

• primary use: To prevent thrombi formation after a stroke (CVA) or myocardial infarction (MI)

  • This is because strokes and MIs are caused by the formation of thromboembolism

• MOA: To alter the plasma membrane of platelets so they cannot aggregate

  • Our anti-platelet drugs will keep our platelets from sticking together

• adverse side effects: Abnormal bleeding, GI bleeding

Clopidogrel

• therapeutic class: Antiplatelet agents

• pharm class: Platelet aggregation inhibitors/Adenosine Diphosphate Inhibitors

• brand name: Plavix

• primary use: To prevent thrombi formation after a stroke (CVA) or myocardial infarction (MI)

• MOA: To alter the plasma membrane of platelets so they cannot aggregate; Inhibits ADP and ATP receptors

  • Our anti-platelet drugs will keep our platelets from sticking together

• adverse side effects: Abnormal bleeding, GI bleeding

Abciximab

• therapeutic class: Antiplatelet agents

• pharm class: Glycoprotein iib iia inhibitors

• brand name: Reopro

• primary use: Used with heparin and aspirin to decrease cardiac ischemia complications before PCI (percutaneous coronary intervention)

• MOA: Binds to glycoproteins on platelet surfaces (GP iib/iia) resulting in decreased platelet aggregation

• adverse side effects: Abnormal bleeding