UNIT 4 Cardiovascular System Antiarrhythmics Unit 4 pt.2

Coagulation

• Coagulation
  
  

• Platelets/thrombocytes
  
  

• Aggregation
  
  

• Thrombus
  
  

• Thromboembolism

  • moving clot becomes lodged

🩸 Blood Clotting (Coagulation) Made SUPER Easy

Think of a blood clot like building a fishing net to stop bleeding. 🎣🩹

🎯The Whole Process in One Line

"Injury → Thromboplastin → Thrombin → Fibrin → Clot"

Step 1: Injury Happens 🚑

A blood vessel gets damaged.

The body says:

"We have a leak!" 🚨

Damaged cells release substances that help start clotting.

Step 2: Thromboplastin Appears

What makes thromboplastin?

✅ Clotting factors

✅ Platelets

✅ Injured tissue cells

"Trauma Makes Thromboplastin" 🤕

When tissue gets injured, thromboplastin is released.

Step 3: Thromboplastin Makes Thrombin Formula:

Thromboplastin → Prothrombin → Thrombin

Think:

Catchy Phrase: "Plastic Makes Pro Become Throm"

"Thromboplastin Turns Pro into Throm"

🩸 Prothrombin = inactive

🩸 Thrombin = active

Step 4: Thrombin Makes Fibrin Formula:

Thrombin → Fibrinogen → Fibrin

Easy Memory: "Thrombin Spins Fibrin" 🕸

Fibrinogen is floating around in the blood.

Thrombin changes it into fibrin.

Step 5: Fibrin Builds the Clot Catchy Phrase:

"Fibrin Fixes the Bleeding" 🕸🩹

Fibrin forms a sticky mesh/net.

The net traps platelets.

This creates a strong clot.

Think:

🧱 Platelets = Bricks

🕸 Fibrin = Cement/Net

❤ Clot = Finished Wall

Coagulation

SUPER IMPORTANT

Main Component of a Clot

⭐ FIBRIN ⭐

"Fibrin = Fishing Net" 🎣

Its job is to hold everything together.

Calcium & Potassium

What do they do?

They help clotting factors work properly.

"No Calcium, No Clot" 🦴❌🩸

Without calcium:

❌ Clotting factors don't work correctly.

❌ Clot formation is impaired.

Breaking Down the Clot

The body doesn't want clots forever.

Once healing occurs:

Catchy Phrase: "Build It, Then Break It" 🩹➡💥

Plasminogen → Plasmin Formula: tPA + Plasminogen = Plasmin

"tPA Turns Plasminogen On" 🔛

tPA activates plasminogen.

What Does Plasmin Do?

Catchy Phrase: "Plasmin Picks Apart Fibrin" ✂🕸

Plasmin dissolves fibrin.

This breaks down the clot.

Think:

🕸 Fibrin = Net

✂ Plasmin = Scissors

Hemostasis Definition

The body must balance:

🩸 Making clothes

And

✂ Breaking clots

Coagulation

🌟 SUPER SHORT STUDY SHEET

"Clot Enough, Not Too Much" ⚖

Too little clotting?

➡ Bleeding

Too much clotting?

➡ Dangerous clots

The perfect balance is called:

Hemostasis ⚖

Clot Formation

1⃣ Injury 🤕

↓

2⃣ Thromboplastin

("Trauma Makes Thromboplastin")

↓

3⃣ Prothrombin → Thrombin

("Thromboplastin Turns Pro into Throm")

↓

4⃣ Fibrinogen → Fibrin

("Thrombin Spins Fibrin")

↓

5⃣ Fibrin Mesh Forms Clot

("Fibrin Fixes the Bleeding")

Clot Breakdown tPA

🔛 Activates plasminogen

↓

Plasmin

✂ Breaks down fibrin

↓

Clot dissolves

Hemostasis

⚖ Balance between:

🩸 Clot formation

✂ Clot breakdown

Coagulation

easy short summary

"Trauma Makes Thromboplastin → Thromboplastin Makes Thrombin → Thrombin Makes Fibrin → Fibrin Forms the Clot → Plasmin Breaks It Apart" 🩸🕸✂✨ 5-Second Exam Trick:

T → T → F → Clot → Plasmin

Thromboplastin → Thrombin → Fibrin → Clot → Plasmin 🎯

🩸 Anticoagulants (Blood Thinners)

Anticoagulants =

Medicines that prevent new blood clots from forming and keep existing clots from getting bigger.

"Too Much Clot? Anticoagulants Stop It!" 🚫🩸 Used For:

• 🦵 DVT (Deep Vein Thrombosis) = clot in a deep vein

• 🦵🔥 Thrombophlebitis = clot + vein inflammation

• 🧠 Stroke

• ❤ MI (Heart Attack)

• 🫁 Pulmonary Embolism (PE) = clot in the lungs

• ❤⚡ Atrial Fibrillation (AFib) = irregular heartbeat that can cause clots

"Legs, Brain, Heart, Lungs"

Anticoagulants help prevent dangerous clots in the:

• 🦵 Legs (DVT)

• 🧠 Brain (Stroke)

• ❤ Heart (MI, AFib)

• 🫁 Lungs (PE)

One-Liner for Exams:

Anticoagulants are used to prevent harmful blood clot formation in conditions such as DVT, thrombophlebitis, stroke, MI, PE, and atrial fibrillation. 🎯🩸

🩸 High Molecular Weight Anticoagulant = Heparin

Anticoagulants

🧠 MOA (How It Works)

"Heparin Helps Prevent Clots" 🚫🩸

"Heparin Halts Thrombin" 🛑

Heparin:

• Stops platelets from sticking together

• Prevents thrombin formation

• Interferes with clotting factors

➡ Result: Less clot formation

💉 Administration

Easy Memory: "Heparin = IV or SubQ Alive"

✅ IV

✅ SubQ

❌ NOT IM → can cause hematoma (bleeding under skin)

❌ NOT Oral → stomach acid destroys it

Test Tip:

✅ Quick onset

✅ Does NOT cross the placenta

🚑 Antidote Easy Memory:

"Heparin? Have Protamine!"

Antidote = Protamine Sulfate

🩸 High Molecular Weight Anticoagulant = Heparin

Anticoagulants

⚠ Side Effects

"Heparin = Watch for Bleeding" 🩸

• Hemorrhage (bleeding)

• Easy bruising

• Epistaxis (nosebleeds)

• Petechiae (tiny red spots)

• Thrombocytopenia (low platelets)

• Fever

• Alopecia (hair loss)

• Osteoporosis (long-term use)

💉 Injection Teaching

"Don't Rub the Hub!"

After injection:

❌ Do NOT massage

✅ Rotate injection sites

❌ Don't inject into bruised areas

---

🌟 Super Short Study Sheet Heparin

🛑 Stops thrombin & clot formation

💉 IV or SubQ only

❌ No IM

❌ Not oral

👶 Does NOT cross placenta

🚑 Antidote = Protamine Sulfate

⚠ Main Side Effect = Bleeding

Ultimate Memory Phrase: "Heparin Halts Thrombin. Heparin? Have Protamine!" 🩸🚫

• Patient teaching/Side effects: risk for hemorrhage, petechiae, fever, alopecia, osteoporosis, thrombocytopenia, do not massage injection site, rotate injection site, do not administer where there is bruising from previous injections, epistaxis, easy bruising

• High molecular weight anticoagulant/

• parenteral=injection
  Anticoagulants

DRUG

heparin

🩸 Low Molecular Weight

Anticoagulant (LMWH)

Example: Enoxaparin (Lovenox)

"Lovenox LOCKS X Factor" 🔒❌X

🧠 MOA (How It Works)

LMWH works by:

✅ Binding to Factor X (Factor Xa)

✅ Preventing clot formation

Easy Memory: "Block X, Stop the Clot" 🛑🩸

💉 How Is It Given?

Easy Memory: "Lovenox Loves SubQ" 💉

✅ SubQ only

❌ Not IM

❌ Not Oral

👶 Does NOT cross the placenta

🚑 Antidote Easy Memory:

"Too Much Lovenox? Protamine Detox!"

Antidote = Protamine Sulfate

⚠ Side Effects Main Problem:

"Watch for Bleeding!" 🩸

Signs:

• Hemorrhage

• Easy bruising

• Epistaxis (nosebleeds)

• Petechiae (tiny red spots)

🩸 Low Molecular Weight

Anticoagulant (LMWH) Example: Enoxaparin (Lovenox)

"Lovenox LOCKS X Factor" 🔒❌

🌟 Super Short Study Sheet

💉 Injection Teaching Catchy Phrase: "Stick It, Don't Rub It!"

✅ Rotate injection sites

✅ Use different areas

❌ Do NOT massage injection site

❌ Do NOT inject into bruised areas

LMWH (Lovenox)

🧠 "Block X, Stop the Clot"

MOA:
🔒 Binds Factor Xa

Administration:
💉 SubQ only

👶 Does not cross placenta

Antidote:
🚑 Protamine Sulfate

Side Effects:
🩸 Bleeding

👃 Nosebleeds

🔴 Petechiae

💜 Easy bruising

Teaching:
❌ Don't massage

✅ Rotate sites

❌ Avoid bruised areas

"Lovenox LOCKS X, Stops Clots, and Watch for Spots!"

🔒 X = Factor Xa

🛑 Clots = prevented

🔴 Spots = petechiae/bleeding signs

ANTICOAGULANTS

• Low molecular weight anticoagulant/parenteral=injection

DRUG

enoxaparin (Lovenox®)

🩸 Oral Vitamin K Antagonist = Warfarin (Coumadin)

Anticoagulants

"Warfarin WARS Against Vitamin K" ⚔🥬

Warfarin works by blocking Vitamin K.

No Vitamin K = fewer clotting factors.

➡ Less clotting

➡Less chance of dangerous blood clots

🧠 MOA (How It Works)

Easy Memory: "No K, No Clot" 🚫🥬🩸

Warfarin:

❌ Prevents the synthesis (making) of clotting factors

❌ Prevents prothrombin production

➡ Blood takes longer to clot

⏰ Onset Easy

Memory: "Warfarin Works Slowly but Stays Long" 🐢

✅ Slow onset

✅ Long duration

👍 Benefits

Easy Memory: "Cheap Pill, Long Protection" 💊

✅ Oral medication

✅ Inexpensive

🚑 Antidote Catchy Phrase:

"Too Much Warfarin? Give Vitamin K!"

Antidote = Vitamin K

🩸 Oral Vitamin K Antagonist = Warfarin (Coumadin)

Anticoagulants

⚠ Side Effects

⚠ Side Effects Main Problem: "Watch for Bleeding!" 🩸

Signs:

💜 Easy bruising, 🦷 Bleeding gums, 🚽 Hematuria (blood in urine)

👃 Nosebleeds, 🤢 Nausea, 🚽 Diarrhea, 😴 Fatigue,🤕 Headache

🥬 Important Food Teaching Test Question Favorite!

Catchy Phrase: "Green Stops the Mean" 🥬

Leafy green vegetables are high in Vitamin K.

Examples:

🥬 Spinach

🥬 Kale

🥬 Collard greens

Too much Vitamin K can:

➡ Decrease Warfarin's effect ➡ Increase clotting risk

"Warfarin Hates Greens" 🥬⚔

You don't have to avoid them completely.

✅Just keep intake consistent.

🚫 Pregnancy Remember: "No Warfarin for Mama" 🤰❌

Warfarin cannot be used during pregnancy.

💊 Patient Teaching

Catchy Phrase: "Same Time, Every Time" ⏰

✅ Take at the same time each day

✅ Watch for bleeding

✅ Check with provider before new medications or supplements

🩸 Oral Vitamin K Antagonist = Warfarin (Coumadin)

Anticoagulants

🌟 Super Short Study Sheet

Warfarin (Coumadin)

🧠 "No K, No Clot"

MOA:
🚫 Vitamin K antagonist

🚫 Decreases clotting factors

🚫 Decreases prothrombin

Benefits:
💊 Oral

💲 Inexpensive

🐢 Slow onset

⏳ Long duration

---

Antidote:
🚑 Vitamin K

---

Side Effects:
🩸 Bleeding

💜 Easy bruising

🦷 Bleeding gums

🚽 Hematuria

👃 Nosebleeds

🤢 Nausea

😴 Fatigue

Teaching:
🥬 Consistent leafy greens

⏰ Same time every day

🤰 Not for pregnancy

Warfarin WARS Against Vitamin K: No K, No Clot. Too Much Warfarin? Give Vitamin K!" ⚔🥬🩸🚑✨

• Oral vitamin K antagonist/ ANTICOAGULANTS

• DRUG

warfarin

🩸 Newer Oral Anticoagulants (DOACs)

DOAC = Direct-Acting Oral Anticoagulant

"DOACs Directly Stop Clots" 🛑🩸

These are newer blood thinners that work directly on clotting factors.

🧠 How They Work (MOA)

There are 2 main types:

1⃣ Direct Thrombin Inhibitors

Easy Memory: "Stop Thrombin, Stop Clotting" 🛑

They directly block thrombin.

2⃣ Direct Factor Xa Inhibitors

Easy Memory: "Block X, Stop the Clot" 🔒❌X

They directly block Factor Xa .

"Thrombin and Xa Build Clots—DOACs Block Both!" 🩸🚫

Uses Catchy Phrase: "Legs, Lungs, and AFib"

Used for:

🦵 Venous thrombosis (DVT)

🦵 Thrombophlebitit

🫁 Pulmonary embolism (PE)

❤⚡ Atrial fibrillation (AFib) with embolization risk

🩸 Newer Oral Anticoagulants (DOACs)

👍 Advantages Over Warfarin

"No Tests, No Greens, No Bridge" 🎉

1⃣ No Routine Blood Monitoring

✅ Do not regulate coagulation checks

2⃣ No Dietary Restrictions

✅ Can eat leafy greens

🥬 No Vitamin K worries

3⃣ No Bridging Needed

✅Usually start working quickly

(No heparin "bridge" needed)

4⃣ Lower Risk of Severe Bleeding

✅ Less risk of life-threatening bleeds compared with warfarin

👎 Disadvantage

Easy Memory: "Easy In, Hard Out"

Some DOACs may not have a readily available antidote in all situations.

Remember: "No Consistent Antidote" 🚑❓

• Disadvantages: no consistent antidote

🩸 Newer Oral Anticoagulants (DOACs)

🌟 Super Short Study Sheet

DOACs

🧠 "DOACs Directly Stop Clots"

MOA

🛑 Direct thrombin inhibitors

🔒Direct Factor Xa inhibitors

Uses

🦵 DVT

🦵 Thrombophlebitis

🫁 PE

❤ AFib

Advantages

✅ No coagulation monitoring

✅ No dietary restrictions

✅ No bridging

✅ Less severe bleeding risk

Disadvantage

❓ No consistent antidote

"DOACs Directly Stop Clots: No Tests, No Greens, No Bridge!" 🩸🚫🥬🌉✨

Warfarin	DOACs
Monitor INR 🩸	No routine monitoring ✅
Watch Vitamin K 🥬	No diet restrictions ✅
Slow onset 🐢	Faster onset ⚡
Often needs bridging 🌉	No bridging ✅
Vitamin K antidote 🚑	No consistent antidote ❓

Warfarin = Watch INR & Vitamin K 🥬

DOACs = Direct, Easy, Less Monitoring 🎯🩸

Newer Oral Anticoagulants

Oral direct thrombin inhibitors (DTIs)

DRUG

                     dabigatran (Pradaxa®)

🩸 Antiplatelets

"No Stick, No Clot!" 🚫🩹

Antiplatelets stop platelets from sticking together.

Normally: 🩹 Platelets stick together → clot forms

With antiplatelets:

❌ Platelets can't stick well

➡ Less clot formation

🧠 MOA (How It Works)

Easy Memory: "Anti-Platelet = Anti-Sticky Platelets"

They:

❌ Inhibit platelet aggregation

❌ Prevent platelets from sticking to each other

❌ Prevent platelets from sticking to vessel walls

➡ Helps prevent clots

Think of It Like This

🧱 Platelets = Bricks

🩹 Clot = Brick Wall

Antiplatelets make the bricks slippery.

Catchy Phrase: "Slippery Platelets Can't Build Clots" 🧱💦

🩸 Antiplatelets

⚠ Side Effects

"Head, Belly, Bleeding, Bruising"

🤕 Headache

Common side effect.

😵 Dizziness

May feel lightheaded.

🤮 Vomiting

It can upset the stomach.

🚽 Diarrhea

Loose stools.

🔴 Rash

Skin irritation may occur.

💜 Easy Bruising

Bruises happen more easily because blood doesn't clot as well.

🩸 Bleeding Signs Catchy Phrase: "If It Bleeds, Report It!"

Watch for:

👃 Nosebleeds (epistaxis)

🦷 Bleeding gums

💜 Easy bruising

🩸 Thrombocytopenia

Low platelet count.

Easy Memory:

"Low Platelets = More Bleeding"

🧪 Lab Monitoring Remember:

"Watch the White Count"

Monitor:

🧪 WBC (White Blood Cell) count

🧪 Platelet count

🩸 Antiplatelets

🌟 Super Short Study Sheet

Antiplatelets MOA

🛑Stop plates from sticking together

🛑 Stop platelets from sticking to vessel walls

Memory "No Stick, No Clot!"

Side Effects

🤕 Headache 😵 Dizziness

🤮 Vomiting 🚽 Diarrhea

🔴 Rash 💜 Easy bruising

🩸 Bleeding gums 👃 Nosebleeds

🩸 Thrombocytopenia

Labs

🧪 Monitor WBC count

🧪 Monitor platelet count

"Antiplatelets Make Platelets Slippery: No Stick, No Clot, But Watch for Bleeding!" 🧱💦🩸✨

5-Second Exam Trick

Anticoagulants = Stop clotting factors 🩸

Antiplatelets = Stop platelets from sticking 🧱

➡ Both prevent clots, but in different ways! 🎯

MOA: inhibit platelet aggregation so platelets no longer stick together or to vessel walls

Newer oral agents (NOACs) or Direct Acting Oral Anticoagulant

         Oral direct factor Xa inhibitors

DRUG

rivaroxaban (Xarelto®)

apixaban (Eliquis®)

edoxaban (Savaysa®)

ANTIPLATELETS

DRUG

aspirin - also known as ASA

         dipyridamole

         clopidogrel (Plavix®)

         prasugrel (Effient®) 

🩸 Safety Measures with Anticoagulants Therapy

"Be Gentle = Prevent Bleeding" 💜

✅ Blow your nose gently → prevent nosebleeds

✅ Use an electric razor → avoid cuts

✅ Use a soft-bristle toothbrush → prevent bleeding gums

✅ Carry a medical ID card/bracelet → lets others know you're on a blood thinner

✅ Check with your healthcare provider before taking OTC medications → some can increase bleeding risk

"Gentle Nose, Gentle Teeth, Gentle Shave, Carry ID, Check OTCs." 🩸✨

The main goal of all these safety measures is to reduce the risk of bleeding while taking anticoagulants. 🚫🩸

🩸 Contraindications to Anticoagulant Therapy

"If You're Already Bleeding, Don't Add a Blood Thinner!" 🚫🩸

❌ Active bleeding → increases bleeding risk

❌ Uncontrolled hypertension (HTN) → risk of bleeding/stroke

❌ Ulcers → can cause GI bleeding

❌ Recent brain or spinal cord surgery → dangerous bleeding risk

❌ Before surgery → clotting labs must be checked first

🎯 Quick Exam Phrase:

"Bleeding, High BP, Ulcers, Brain/Spine Surgery = No Anticoagulants!" 🩸🚫

🩸 PTT (Partial Thromboplastin Time)

PTT is a blood test used to monitor Heparin therapy.

It tells us: "How long does it take blood to clot?" ⏱🩸

"PTT = Time To Thicken" ⏰🩸

Higher PTT = blood takes longer to clot

Lower PTT = blood clots faster

Normal PTT

✅ 20–35 seconds

When a patient is on Heparin:

Goal: 2× Normal

Example:

Normal = 20–35 sec

Therapeutic range ≈ 40–70 sec

Your Example

Patient PTT = 80 seconds

Goal = about 40–70 seconds

80 seconds is: ⬆ TOO HIGH

What Does 80 Seconds Mean?

Easy Memory: "Higher PTT = Higher Bleeding Risk" 🩸⚠

✅ Blood is THIN

✅ Clotting is SLOW

❌ Blood is NOT thick

❌ Clotting is NOT fast

What Should Happen?

Catchy Phrase: "PTT Too High? Turn Heparin Down!" ⬇💉

Because 80 seconds is above the therapeutic range:

➡ Decrease the Heparin dose

PTT-Partial Thromboplastin Time

side by side

PTT Result	Blood	Clotting	Heparin Dose
Too Low	Thick 🩸	Fast ⚡	Increase ⬆
Normal Goal	Just Right ✅	Controlled 👍	Keep Same
Too High (80 sec)	Thin 💧	Slow 🐢	Decrease ⬇

🩸 What is PTT?

Think of PTT as a stopwatch for clotting ⏱

High PTT = Long Time to Clot

Low PTT = Short Time to Clot

It measures:

"How long does it take blood to clot?"

"High PTT = Thin Blood = Slow Clotting = Lower the Heparin!" 🩸⬇💉 Exam Question:

PTT = 80 sec

✅ Blood is thin

✅ Clotting is slow

✅ Decrease Heparin dose 🎯

PTT-Partial Thromboplastin Time

easy short summary

Think About Honey 🍯 Thick Honey

• Moves slowly

• Sticks together easily

= Blood clots fast
= Low PTT

Watery Honey 💧

• Runs easily

• Doesn't stick together well

= Blood clots slowly
= High PTT

Heparin's Job

Heparin is a blood thinner.

Catchy Phrase: "Heparin Makes PTT Go Up" ⬆

More heparin = blood takes longer to clot = PTT increases.

Your Example = Normal PTT:

20–35 seconds

For a patient on heparin:

Goal: About 40–70 seconds

Patient's PTT:

80 seconds

Ask yourself:

Is 80 bigger than 70?

✅ YES

So the blood is taking too long to clot.

What Does That Mean? PTT = 80

✅ Blood is thin ✅ Clotting is slow ✅ Higher bleeding risk

❌ Blood is not thick ❌ Clotting is not fast

What Should the Nurse Do?

If heparin makes PTT go up...

And PTT is already too high...

Catchy Phrase: "PTT Too High? Less Heparin!"

➡ Decrease the heparin dose.

PTT	Blood	Action
LOW	Thick 🩸	Increase heparin ⬆
HIGH	Thin 💧	Decrease heparin ⬇

"High PTT = High Bleeding Risk" 🩸⚠

SW:

PTT = 80 seconds
→ Blood is thin 💧
→ Clotting is slow 🐢
→ Decrease heparin ⬇💉

PT/INR - Prothrombin Time

🩸 PT/INR = Warfarin Blood Test

What is PT/INR?

Think of INR as a clotting speed test ⏱🩸

It tells us: "How long does it take the blood to clot?"

HIGH INR = Blood is THIN 💧 LOW INR = Blood is THICK 🩸

Why?

• High INR = takes longer to clot

• Low INR = clots faster

Warfarin's Job

Warfarin is a blood thinner.

Catchy Phrase: "Warfarin Raises INR" ⬆

More warfarin → higher INR → thinner blood

Normal INR

Without warfarin:
➡ About 1

For someone taking warfarin:

Goal: INR = 2–4

This means:
✅ Blood is thinner
✅ Clotting is slower
✅ Medication is working

Your Example: INR = 1.7

Ask:

Is 1.7 within the goal range of 2–4?

❌ No, it is TOO LOW.

What Does a Low INR Mean? INR = 1.7

🩸 Blood is too thick

⚡ Clotting is too fast

⚠ Higher risk of forming clots

What Should Happen?

Because the blood is too thick:

Catchy Phrase: "INR Too Low? Need More Warfarin!" ⬆💊

➡ Increase the warfarin dose (provider will adjust)

PT/INR - Prothrombin Time

side by side summary

INR Level	Blood	Clotting	Warfarin
LOW INR (1.7)	Thick 🩸	Fast ⚡	Increase ⬆
Goal INR (2–4)	Thin enough ✅	Controlled	Keep same
HIGH INR	Too thin 💧	Slow 🐢	Decrease ⬇

Compare PTT vs INR (Easy Trick) 🩸 Heparin → PTT

"H = Heparin = PTT"

💊 Warfarin → PT/INR

"W = Warfarin = INR"

---

🎯 Ultimate Memory Phrase:

"Low INR = Thick Blood = Fast Clot = More Warfarin" 🩸⬆💊

"High INR = Thin Blood = Slow Clot = Less Warfarin" 💧⬇💊

🩸 Thrombolytic Enzymes = "Clot Busters" 💥🩸

"Thrombolytics Break the Clot!" 🧱💥

These medications destroy existing blood clots .

Think:

🩸 Anticoagulants = prevent new clots

💥 Thrombolytics = break up clots that are already there

🧠 MOA (How They Work) Easy Memory: "Plasmin = Clot Cutter" ✂🩸

The steps:

1⃣ Thrombolytics activate plasminogen

⬇

2⃣ Plasminogen turns into plasmin

⬇

3⃣ Plasmin breaks down fibrin

⬇

4⃣ Clot dissolves ( fibrinolysis )

tPA → Plasminogen → Plasmin → Breaks Fibrin → Clot Gone ✂🩸

Uses (When Do We Use Them?) Catchy Phrase: "Heart, Brain, Lung, Leg Clots Get Busted!" 💥

Used for:

❤ MI (heart attack)
→ coronary artery thrombosis

🫁 Pulmonary embolism (PE)
→ clot in lungs

🧠 Stroke
→ clot blocking blood flow

🦵 DVT
→ clot in deep veins

Thrombolytic Enzymes (Clot-Busters)

⚠ Side Effects

Main Risk: "Breaking Clots Can Cause Bleeding" 🩸⚠

Because thrombolytics dissolve clots, they can also increase bleeding risk.

1⃣ Hemorrhage 🩸

• Serious bleeding risk

• Higher risk when combined with anticoagulants

Memory: "More Blood Thinners = More Bleeding Risk"

2⃣ Arrhythmias ❤⚡

When a clot breaks apart and blood flow returns to the heart, abnormal rhythms can occur.

Thrombolytic Enzymes (Clot-Busters)

🌟 Super Short Study Sheet

Thrombolytics (Clot-Busters) Job:

💥 Break up existing closets

MOA:

🧬 Activate plasminogen → plasmin

✂ Plasmin breaks fibrin

🩸 Clot dissolves

Uses:

❤ MY

🫁 PE

🧠 Stroke

🦵 DVT

Side Effects:

⚠ Hemorrhage

❤ Arrhythmias

⚠ Increased bleeding with anticoagulants

"Thrombolytics Turn Plasmin On → Plasmin Cuts Fibrin → The Clot Falls Apart!" ✂🩸 Quick Test Trick:

Anticoagulants = Stop clots from forming 🚫

Thrombolytics = Smash clots already there 💥

Thrombolytic Enzymes (Clot-Busters)

DRUG

         alteplase (tPA) 

🩸 Coagulants (Clot Helpers)

Coagulants help the body stop bleeding by helping form clots.

Catchy Phrase: "Coagulants Create Clots"

🩸Use:

✅ Decrease the chance or severity of hemorrhage (bleeding)

MOA (How They Work):

They:

• ✅ Promote clotting

• ✅ Activate fibrin (the clot “net”)

• ✅ Help make clotting factors

Easy Memory: "Coagulants Build the Blood Clot Wall" 🧱🩸

Coagulants = Help make clots
Anticoagulants = Prevent clots 🎯

• Use: to decrease incidence or severity of hemorrhage
  

• MOA: promotes clotting, activates fibrin, assists in clotting factor formation
  

COAGULANTS

DRUG

Vitamin K (Aquamephyton®)

 thrombin powder

Cardiovascular Contraindications to Dental Patient

Super Easy Idea:

Before dental procedures, we want the heart to be stable .

Catchy Phrase: "Unstable Heart = Wait Before Dental Work" ❤⏸

Some heart conditions increase the risk of complications.

🚫 Conditions to Watch For

1⃣ Recent Myocardial Infarction (MI) ❤

Heart attack within the last 3–6 months

Memory:

"Fresh Heart Attack = Give the Heart Time"

The heart needs time to recover.

2⃣ Unstable Angina 💔

Chest pain that is:

• New

• Getting worse

• Not controlled

Memory: "New Chest Pain = No Dental Strain"

3⃣ Uncontrolled Congestive Heart Failure (CHF) 💧❤

The heart is not pumping well.

Memory: "Weak Pump = Higher Risk"

4⃣ Uncontrolled Arrhythmias ⚡❤

Abnormal heart rhythms that are not controlled

Memory: "Irregular Rhythm = Be Cautious"

5⃣ Uncontrolled Hypertension 🩸

Very high blood pressure that is not controlled.

Memory: "High Pressure = High Risk"

6⃣ Valve Abnormalities ❤

Some heart valve problems may require:

✅ Antibiotic treatment before dental procedures

Memory:

"Bad Valves May Need Antibiotics"

Cardiovascular Contraindications to Dental Patient

🌟 Quick Study Sheet

Avoid/Delay Dental Treatment With:

❤ Recent MI (3–6 months)

💔 Unstable angina

💧 Uncontrolled CHF

⚡ Uncontrolled arrhythmias

🩸 Uncontrolled hypertension

❤ Valve problems (may need antibiotics)

🎯 Ultimate Memory Phrase: "Heart Attack, Chest Pain, Weak Pump, Bad Rhythm, High Pressure, Bad Valves = Check Before Dental!" ❤🦷

Main idea: A stable heart can handle dental stress; an unstable heart needs extra care.