Pharmacology Exam 2 - Everything on the test was
exactly in these notes (Pharmacology I)
, lOMoAR cPSD| 47061011
Chp 26
Hemostasis
- The stopping of a flow of blood
- Coagulation is hemostasis that occurs because of the physiologic clotting of blood
- Thrombus: Blood clot (stationary)
- Embolus: thrombus that moves through blood vessels.
Coagulation System
- The Liver is responsible for the clotting cascade.
o The liver activates prothrombin, then it turns into a thrombin, which then turn
into fibrinogen and then becomes fibrin which forms a mesh that attracts the
platelets and stop the bleeding.
Fibrinolytic System
- Initiates the breakdown of clots and serves to balance the clotting process
- Fibrinolysis o mechanism by which formed thrombi are lysed (destroyed) to prevent
excessive clot formation and blood vessel blockage
Hemophilia
- Rare genetic disorder
- Lacks certain clotting factors.
- Patients with hemophilia can bleed to death if coagulation factors are not given.
Coagulation Modifier Drugs
- Anticoagulants o Prevents clot formation
o It does not dissolve clots and it doesn’t have any action on platelets
- Antiplatelet drugs o Inhibit platelet aggregation (clumping together of platelets) o
Prevent platelet plug
Ex: Aspirin
- Thrombolytic drugs o Lyse (break down) existing clots
Anticoagulants
- Also known as antithrombotic
- Can be used prophylactically to prevent clots
- Does not help with a blood clot that is already formed
- Prevent intravascular thrombosis by decreasing blood coagulability
- Used prophylactically to prevent o Clot formation (thrombus) o An embolus
(dislodged clot) Embolus
- Thromboembolic events
, lOMoAR cPSD| 47061011
o Myocardial infarction (MI): embolus lodges in a coronary artery o Stroke:
embolus obstructs a brain vessel o Pulmonary emboli: embolus in the
pulmonary circulation o Deep vein thrombosis (DVT): embolus goes to a vein
in the leg
Anticoagulants Drugs (KNOW THIS)
- Heparins-part 1 o Given prophylactically to prevent clots
- Low-molecular- weight heparins (LMWH) o Enoxaparin (Lovenox)
A subcutaneous heparin given prophylactically to prevent clots.
This Is only given Sub q
No lab valued to be monitored.
o Dalteparin (Fragmin)
- Heparins- part 2 o Un-fractioned heparin (given IV only)
This is NOT prophylactic, this is for someone who has a
thromboembolic event.
Patient usually get this on IV drip or a bolus o Must monitor PTT
lab value when someone is on IV heparin.
Warfarin (Coumadin)
- Comes PO only
- Mechanical heart valve
- Most commonly prescribed oral anticoagulant
- Careful monitoring of the prothrombin time/international normalized ratio (PT/INR)
- A normal INR (without warfarin) is 1.0, but a therapeutic INR (with warfarin) ranges
from 2 to 3.0, (3.0-3.5 mechanical valve) depending on the indication for use of the
drug (e.g., atrial fibrillation, thromboprevention, prosthetic heart valve).
- Many drug interactions
- Dietary considerations: Green leafy vegetables (Don’t eat too much)
Nursing Implications Warfarin (Coumadin)
- May be started while the patient is still on heparin until PT/INR levels indicate adequate
anticoagulation
- Full therapeutic effect takes several days.
- Monitor PT/INR regularly; keep follow-up appointments. - Antidote is vitamin
K.
Treatment: Toxic Effects of Warfarin (KNOW THIS)
- Discontinue the warfarin.
- May take 36 to 42 hours before the liver can resynthesize enough clotting factors to
reverse the warfarin effects
exactly in these notes (Pharmacology I)
, lOMoAR cPSD| 47061011
Chp 26
Hemostasis
- The stopping of a flow of blood
- Coagulation is hemostasis that occurs because of the physiologic clotting of blood
- Thrombus: Blood clot (stationary)
- Embolus: thrombus that moves through blood vessels.
Coagulation System
- The Liver is responsible for the clotting cascade.
o The liver activates prothrombin, then it turns into a thrombin, which then turn
into fibrinogen and then becomes fibrin which forms a mesh that attracts the
platelets and stop the bleeding.
Fibrinolytic System
- Initiates the breakdown of clots and serves to balance the clotting process
- Fibrinolysis o mechanism by which formed thrombi are lysed (destroyed) to prevent
excessive clot formation and blood vessel blockage
Hemophilia
- Rare genetic disorder
- Lacks certain clotting factors.
- Patients with hemophilia can bleed to death if coagulation factors are not given.
Coagulation Modifier Drugs
- Anticoagulants o Prevents clot formation
o It does not dissolve clots and it doesn’t have any action on platelets
- Antiplatelet drugs o Inhibit platelet aggregation (clumping together of platelets) o
Prevent platelet plug
Ex: Aspirin
- Thrombolytic drugs o Lyse (break down) existing clots
Anticoagulants
- Also known as antithrombotic
- Can be used prophylactically to prevent clots
- Does not help with a blood clot that is already formed
- Prevent intravascular thrombosis by decreasing blood coagulability
- Used prophylactically to prevent o Clot formation (thrombus) o An embolus
(dislodged clot) Embolus
- Thromboembolic events
, lOMoAR cPSD| 47061011
o Myocardial infarction (MI): embolus lodges in a coronary artery o Stroke:
embolus obstructs a brain vessel o Pulmonary emboli: embolus in the
pulmonary circulation o Deep vein thrombosis (DVT): embolus goes to a vein
in the leg
Anticoagulants Drugs (KNOW THIS)
- Heparins-part 1 o Given prophylactically to prevent clots
- Low-molecular- weight heparins (LMWH) o Enoxaparin (Lovenox)
A subcutaneous heparin given prophylactically to prevent clots.
This Is only given Sub q
No lab valued to be monitored.
o Dalteparin (Fragmin)
- Heparins- part 2 o Un-fractioned heparin (given IV only)
This is NOT prophylactic, this is for someone who has a
thromboembolic event.
Patient usually get this on IV drip or a bolus o Must monitor PTT
lab value when someone is on IV heparin.
Warfarin (Coumadin)
- Comes PO only
- Mechanical heart valve
- Most commonly prescribed oral anticoagulant
- Careful monitoring of the prothrombin time/international normalized ratio (PT/INR)
- A normal INR (without warfarin) is 1.0, but a therapeutic INR (with warfarin) ranges
from 2 to 3.0, (3.0-3.5 mechanical valve) depending on the indication for use of the
drug (e.g., atrial fibrillation, thromboprevention, prosthetic heart valve).
- Many drug interactions
- Dietary considerations: Green leafy vegetables (Don’t eat too much)
Nursing Implications Warfarin (Coumadin)
- May be started while the patient is still on heparin until PT/INR levels indicate adequate
anticoagulation
- Full therapeutic effect takes several days.
- Monitor PT/INR regularly; keep follow-up appointments. - Antidote is vitamin
K.
Treatment: Toxic Effects of Warfarin (KNOW THIS)
- Discontinue the warfarin.
- May take 36 to 42 hours before the liver can resynthesize enough clotting factors to
reverse the warfarin effects
