Hematology Medications

Anticoagulants

alter the coagulation cascade (warfarin, heparin)

Antiplatelets

prevents platelet aggregation (aspirin, clopidogrel, prasugrel)

Thrombolytics

dissolve existing clots

Warfarin

• C - anticoagulant

• A - direct thrombin inhibitor

• E - monitor PT INR

  • antidote Vitamin K

  • works slowly

• C/I - unsafe for pregnancy

Dibigatran

• C - anticoagulant

• A - directly blocks thrombin IIA

  • fewer interactions bc it’s a Direct Xa inhibitor

• SE -

• Ed -

• C/I -

• O -

Heparin

• C - anticoagulant

• A - for acute clot management

• E - IV / Sub Q

  • antidote = protamine sulfate

  • monitor aPTT

• C/I - safe for pregnancy

Alteplase (tPA)

• C - thrombolytics

• A - converts plasminogen into plasmin - plasmin breaks down fibrin clots

  • acute MI, ischemic stroke, massive PE

• SE -

• Ed - HIGH bleeding risk, must be given in a strict time window

• C/I -

• O -

Aspirin

• C - antiplatelet

• A -

• SE - bleeding!

• Ed -

  • low dose = 81mg = prevents CVA, MI, reinfarction, long term

  • Regular = 325mg = give at first sign of MI, chew

• C/I - taking ASA therapy

• O -

Clopidogrel (plavix)

• C -

• A -

• SE - bleeding risk!

• Ed - used in combination with ASA for dual anti platelet therapy

  • after stent placement or acute coronary syndrome

  • dc 7 days before surgery

• C/I -

• O -