Exam (elaborations)
Pharm 895 Antiplatelet & Anticoagulant (1)
- Course
- Institution
Pharm 895 Antiplatelet & Anticoagulant (1)
[Show more]
Seller
Follow
lydiaomutho
Content preview
Pharm 895 Antiplatelet & AnticoagulantDrugs that are monitored via PTT - CORRECT ANSWER--Heparin.
-Angiomax: bivalirudin.
-Argatroban.
Drugs that are monitored via factor Xa - CORRECT ANSWER--LMWH.
-Arixtra: fondaparinux.
Drugs that are monitored via PT/INR - CORRECT ANSWER--Coumadin: warfarin.
Asprin - CORRECT ANSWER--MOA: Antiplatelet, inhibits prostaglandin synthesis
through irreversible COX inhibition.
-AE: Dyspepsia, bleeding, asthma exacerbation, rare rash, hepatotoxicity (in OD),
thrombocytopenia.
-Reye's Syndrome.
-Recommended in pts with unprovoked proximal DVT/PE who are stopping
anticoagulation
Platelet P2Y12 inhibitors - CORRECT ANSWER--AE: Bleeding, dyspepsia, rare
rash, HA.
-Clopidogrel: prodrug, must be enterically & hepatically metabolized.
-Prasugrel: prodrug, must be enterically metabolized.
-Ticagrelor: taken in active form.
Plavix: clopidogrel - CORRECT ANSWER--Platelet P2Y12 inhibitor.
-Increased risk of thromboembolic events when taken with certain PPIs.
Effient: prasugrel - CORRECT ANSWER--Platelet P2Y12 inhibitor.
-3A4 substrate.
-Contraindicated after TIA or stroke
Brilinta: ticagrelor - CORRECT ANSWER--Platelet P2Y12 inhibitor, reversible.
-AE: Dyspnea.
-3A4 substrate, 2C9 inhibitor.
Kengreal: cagrelor - CORRECT ANSWER--Platelet P2Y12 inhibitor.
-IV only. Do not administer clopidogrel or prasugrel during infusion.
PAR-1 Antagonist - CORRECT ANSWER--Zontivity: vorapaxar, w/ aspirin or
clopidogrel.
-Effectively irreversible because of long half-life.
-Indicated for patients with prior MI or PAD.
-AE: bleeding, anemia, rash, depression.
, -Avoid in h/o stroke, TIA, intracranial hemorrhage, or severe hepatic impairment.
-Monitor CBC
Aggrenox: dipyridamole - CORRECT ANSWER--ONLY used in combination therapy
with aspirin.
-Vasodilator, prevents platelet aggregation by inhibiting adenosine uptake and cGMP
activity.
-Indication: stroke prevention after TIA.
-AE: bleed, HA (from vasodilation), abd pain, diarrhea, nausea, dyspepsia
Aggrenox: dipyridamole how to avoid headaches - CORRECT ANSWER--For first
several weeks, dose only q HS.
-Then move to BID, typically headaches from vasodilation decrease over time.
Aspirin nonadherence - CORRECT ANSWER--Very common for patients to stop
taking aspirin, because it's OTC and seen as less important.
-Aspirin has been proven to be one of the most effective medicines to prevent an
acute ischemic attack.
-Write a prescription for aspirin to convey its importance to patients.
Fibrinolytics - CORRECT ANSWER--Alteplase, aka tPA, Activase, Cathflo, is most
commonly used.
-Converts plasminogen to plasmin, causes fibrinolysis through proteolytic digestions
of fibrin.
-Dose </= 100mg.
-Indications: acute ischemic stroke, PE, acute MI, catheter clearance, others.
-AE: bleeding, rare angioedema.
Fibrinolysis inhibitors - CORRECT ANSWER--Aminocaproic acid, tranexamic acid.
-AE: thrombosis. Rare AE: myopathy, hypotension, abdominal discomfort, diarrhea,
blood dyscrasias.
-Monitor: CBC, fibrinogen, BUN, Cr.
Unfractionated Heparin - CORRECT ANSWER--Mixture of molecules of different
weights & activity.
-Prophylactic dose: 5000 U q 12/8.
-Treatment dose: 10 to 20 U/kg/hr on average, titrated to PTT or anti-Xa units.
-Binds to antithrombin III which inhibits factors IIa, IXa, and Xa.
Unfractionated Heparin AE, monitoring, antidote - CORRECT ANSWER--AE:
bleeding, rare thrombocytopenia, alopecia, hepatotoxicity, very rare hypersensitivity
rxn.
-Monitoring: PTT most common, most variable. Anti-Xa level much more predictable
between labs, but more expensive. CBC, platelets, potassium.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lydiaomutho. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67866 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now