NUR 378 EXAM 1 PHARMACOLOGY FULL
STUDY COMPANION 2026
◉ What are the therapeutic indications of the direct thrombin
inhibitors? Answer: - Atrial Fibrillation:
- prevents stroke and systemic embolism in patients with non-
vavular atrial fibrillation
- DVT and PE
- Knee or Hip replacement
- DVT/PE treatment
◉ What is the adverse effect common to all of the direct thrombin
inhibitors? Answer: - Bleeding
- GI disturbances: dyspepsia, gastritis-like symptoms
◉ How will the nurse monitor a client on a direct thrombin inhibitor
infusion? Answer: - Platelet count
◉ What teaching will the nurse provide for a client prescribed a
direct thrombin inhibitor for prophylaxis therapy? Answer: Take
with meals to lower GI disturbances
,◉ What are the expected pharmacological effects of the direct factor
Xa inhibitors (Ex. rivaroxaban)? Answer: Binds directly with Factor
Xa to inhibit production of thrombin
◉ What are the therapeutic indications of the direct factor Xa
inhibitors (Ex. rivaroxaban)? Answer: - Prevent DVT and PE
following hip and knee replacement
- Prevent Stroke in clients with atrial fibrillation
- Treat DVT and PE unrelated to orthopedic surgery
◉ What is the adverse effect common to all of the direct factor Xa
inhibitors? Answer: - Bleeding
- Spinal/Epidural hematoma
◉ What is the mechanism of action by which aspirin acts as an
antiplatelet drug? Answer: Inhibits cyclooxygenase to prevent
platelets from synthesizing TXA2, which prevents promotion of
platelet activation and vasoconstriction in VSM, resulting in
decreased risk of arterial thrombosis
◉ What are the anticoagulant therapeutic indications for aspirin?
Answer: - Reduce risk of ischemic stroke
- Reduce risk of death in TIAs
- Reduce risk of MI and sudden death (Chronic stable angina)
,- Reduce risk of death and nonfatal MI (stable angina)
- Reduce Coronary stenting
- Reduce vascular mortality (Acute MI)
- Reduce recurrent MI
- Primary prevention of MI
◉ What are the chief adverse effects of aspirin? Answer: - GI
Bleeding
- Hemorrhagic stroke
◉ What are the expected pharmacological effects of clopidogrel
(P2Y12 Adenosine Diphosphate Receptor Antagonists)? Answer:
Blocks P2Y12 ADP receptors on platelet surfaces to prevent ADP-
stimulated aggregation of platelets (irreversible) to reduce risk
blockage
◉ What are the therapeutic indications of clopidogrel? Answer:
Prevents bloackage in coronary artery stents, which reduces
thrombotic events (MI, ischemic stroke, vascular death)
◉ What are the most common adverse effects of clopidogrel?
Answer: - Abdominal pain, dyspepsia, diarrhea, rash
- Bleeding ( GI or Brain)
, - Thrombotic Thrombocytopenic Purpura (TTP): thrombocytopenia,
hemolytic anemia, neurologic symptoms, renal dysfunction, fever
◉ What are the most potentially fatal adverse effects of clopidogrel?
Answer: Thrombotic Thrombocytopenic Purpura (TTP):
thrombocytopenia, hemolytic anemia, neurologic symptoms, renal
dysfunction, fever
◉ How can "poor metabolizers" of clopidogrel be identified?
Answer: Clients with variant CYP2C19 genes
Should not take clopidogrel if client has this
◉ Explain the most significant drug-drug interactions for
clopidogrel. Answer: - Drugs that promote bleeding: warfarin,
aspirin, NSAIDs, Heparin
- Proton Pump Inhibitors (PPI): inhibit hepatic CYP2C19, which is
needed to convert clopidogrel to its active form --> reduces
antiplatelet effects
◉ What assessments should the nurse perform before administering
clopidogrel? Answer: Test for variants of CYP12C19 gene
STUDY COMPANION 2026
◉ What are the therapeutic indications of the direct thrombin
inhibitors? Answer: - Atrial Fibrillation:
- prevents stroke and systemic embolism in patients with non-
vavular atrial fibrillation
- DVT and PE
- Knee or Hip replacement
- DVT/PE treatment
◉ What is the adverse effect common to all of the direct thrombin
inhibitors? Answer: - Bleeding
- GI disturbances: dyspepsia, gastritis-like symptoms
◉ How will the nurse monitor a client on a direct thrombin inhibitor
infusion? Answer: - Platelet count
◉ What teaching will the nurse provide for a client prescribed a
direct thrombin inhibitor for prophylaxis therapy? Answer: Take
with meals to lower GI disturbances
,◉ What are the expected pharmacological effects of the direct factor
Xa inhibitors (Ex. rivaroxaban)? Answer: Binds directly with Factor
Xa to inhibit production of thrombin
◉ What are the therapeutic indications of the direct factor Xa
inhibitors (Ex. rivaroxaban)? Answer: - Prevent DVT and PE
following hip and knee replacement
- Prevent Stroke in clients with atrial fibrillation
- Treat DVT and PE unrelated to orthopedic surgery
◉ What is the adverse effect common to all of the direct factor Xa
inhibitors? Answer: - Bleeding
- Spinal/Epidural hematoma
◉ What is the mechanism of action by which aspirin acts as an
antiplatelet drug? Answer: Inhibits cyclooxygenase to prevent
platelets from synthesizing TXA2, which prevents promotion of
platelet activation and vasoconstriction in VSM, resulting in
decreased risk of arterial thrombosis
◉ What are the anticoagulant therapeutic indications for aspirin?
Answer: - Reduce risk of ischemic stroke
- Reduce risk of death in TIAs
- Reduce risk of MI and sudden death (Chronic stable angina)
,- Reduce risk of death and nonfatal MI (stable angina)
- Reduce Coronary stenting
- Reduce vascular mortality (Acute MI)
- Reduce recurrent MI
- Primary prevention of MI
◉ What are the chief adverse effects of aspirin? Answer: - GI
Bleeding
- Hemorrhagic stroke
◉ What are the expected pharmacological effects of clopidogrel
(P2Y12 Adenosine Diphosphate Receptor Antagonists)? Answer:
Blocks P2Y12 ADP receptors on platelet surfaces to prevent ADP-
stimulated aggregation of platelets (irreversible) to reduce risk
blockage
◉ What are the therapeutic indications of clopidogrel? Answer:
Prevents bloackage in coronary artery stents, which reduces
thrombotic events (MI, ischemic stroke, vascular death)
◉ What are the most common adverse effects of clopidogrel?
Answer: - Abdominal pain, dyspepsia, diarrhea, rash
- Bleeding ( GI or Brain)
, - Thrombotic Thrombocytopenic Purpura (TTP): thrombocytopenia,
hemolytic anemia, neurologic symptoms, renal dysfunction, fever
◉ What are the most potentially fatal adverse effects of clopidogrel?
Answer: Thrombotic Thrombocytopenic Purpura (TTP):
thrombocytopenia, hemolytic anemia, neurologic symptoms, renal
dysfunction, fever
◉ How can "poor metabolizers" of clopidogrel be identified?
Answer: Clients with variant CYP2C19 genes
Should not take clopidogrel if client has this
◉ Explain the most significant drug-drug interactions for
clopidogrel. Answer: - Drugs that promote bleeding: warfarin,
aspirin, NSAIDs, Heparin
- Proton Pump Inhibitors (PPI): inhibit hepatic CYP2C19, which is
needed to convert clopidogrel to its active form --> reduces
antiplatelet effects
◉ What assessments should the nurse perform before administering
clopidogrel? Answer: Test for variants of CYP12C19 gene
