Pharmacology Exam 3
Terms in this set (364)
Original
any process that stops bleeding
hemostasis
hemostasis that occurs because of the physiologic clotting of blood
coagulation
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blood clot
thrombus
thrombus that moves through blood vessels
embolus
Ultimate result is fibrin, a clot-forming substance
coagulation system
inhibit the action/formation of clotting factors and prevent clot formation
anticoagulants
inhibit platelet aggregation and prevent platelet plugs
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anti platelet drugs
alter platelet function without preventing the platelets from working
hemorheologic drugs
lyse (break down) existing clots
thrombolytic drugs
promote blood coagulation
antifibrinolytic or hemostatic
What are anticoagulants also known as?
antithrombotic drugs
Prevent intravascular thrombosis by decreasing blood coagulability and used prophylactically to
prevent clot formation and an embolus
anticoagulants
What drug's mechanism of action is to inhibit clotting factors IIa (thrombin) and Xa?
heparin
What do low-molecular-weight heparins bind to?
Factor 10
Enoxaparin and Dalteparin are examples of what?
low-molecular-weight heparins
How is enoxaparin administered?
SQ
,What is not required when a patient is on subcutaneous heparin?
lab monitoring
What lab should be monitored when a patient is on heparin?
aPTT
Which drug's mechanism of action is to inhibit vitamin K-dependent clotting factor II, IX, and X
(normally synthesized in liver) and inhibit vitamin K synthesis by bacteria in the GI tract?
warfarin
What is an example of a factor Xa inhibitor?
Fondaparinux (SQ)
What is the black box warning of fondaparinux?
spinal hematomas in pt w/ epidural catheter
When would you not give fondaparinux?
8 hours post-op and to a pt w/ renal failure
What are two examples of Direct Oral Anticoagulants?
rivaroxaban and apixaban
What do rivaroxaban and apixaban not require?
lab monitoring
-aban
direct oral anticoagulants
Which drug's mechanism of action is to inhibit thrombin (factor IIa), they are not used as frequently?
direct thrombin inhibitors
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What are two examples of synthetic direct thrombin inhibitors?
bivalirudin and dabigatran
Used to prevent clot formation in certain setting where clot formation is likely; MI, unstable angina,
atrial fibrillation, indwelling devices (mechanical heart valve), and major orthopedic surgery.
Anticoagulants
What is warfarin strongly contraindicated in?
pregnancy
What are low-molecular-weight heparins strongly contraindicated in?
pt w/ an indwelling epidural catheter, can cause epidural hematoma
What is the main adverse effect of anticoagulants?
bleeding
What adverse effect can occur in heparin?
heparin-induced thrombocytopenia
What is an unique adverse effect of warfarin?
skin necrosis and "purple toes" syndrome
What do hematuria, melena (blood in stool), petechiae, ecchymoses, and gum or mucous membrane
bleeding indicate?
toxic effects of heparin
What is the reversal agent of heparin?
, protamine sulfate
What is the reversal agent of warfarin?
Vitamin K
How long can warfarin resistance occur after giving vitamin K?
up to 7 days
What is the only exception to questioning an order if two anticoagulants are ordered?
bridge therapy with heparin/enoxaparin and PO warfarin
transition for pt to go on PO warfarin so that they can go home
bridge therapy
Which drug is used for prophylaxis and treatment, and usually comes in a pre-filled syringe where you
should NOT expel air bubbles?
enoxaparin
Which drug is used for prevention of stroked in patients with a-fib, post-op thromboprophylaxis w/
orthopedic surgeries, and treatment of DVT and PE?
rivaroxaban
Which labs should be monitored when a patient is on warfarin?
PT/INR
What is a therapeutic range of INR when a patient is on warfarin?
2 to 3.5
A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night before.
Which statement is most correct?
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A. The patient is receiving a double dose of anticoagulants.
B. The heparin therapy was ineffective, so the warfarin was started.
C. The heparin provides anticoagulation until therapeutic levels of warfarin are reached.
D. The heparin and warfarin work together synergistically to provide anticoagulation.
C
work to prevent platelet adhesion at the site of blood vessel injury (collagen from damaged vessels
stimulate platelet adhesion)
anti platelet drugs
What are examples of anti-platelet drugs?
aspirin, clopidogrel, ticagrelor
What are examples of older thrombolytic drugs?
streptokinase and urokinase
What is an example of a current thrombolytic drug known as a t-plasminogen activator (tPa)?
alteplase (IV)
Which drug's mechanism of action is to active the fibrinolytic system to break down the clot in the
blood vessel quickly, activate plaminogen and convert it to plasmin (to digest fibrin), and reestablish
blood flow to the heart muscle?
thrombolytic drugs
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