NYU Pharmacology Exam 1 Final PREP Questions With Correct Answers 2023 Graded 100%

NYU Pharmacology Exam 1 Final PREP Questions With Correct Answers 2023 Graded 100%. Low molecular weight heparin - ENOXAPARIN - ANSWER MOA: -Binds with antithrombin and accelerates the rate at which antithrombin inhibits Factor Xa and thrombin ANTIDOTE: - protamine sulfate. however, less effective than with unfractioned hep. considerations comparison to unfractioned heparin: - dec risk bleeding -more stable response - DOES NOT REQUIRE APTT MONITOR!!! -half life is 2-4x that of heparin -Thrombocytopenia is less likely Warfarin - ANSWER MECALL INDICATION: -prevent thromboembolic ie: - CT/DVT/PE ANTIDOTE: - VITAMIN K -FRESH FROZEN PLASMA FOR ACTUE BLEEDING MOA: -inhibits hepatic synthesis of coag factors dependent on Vit K, factors 2, 7, 9, 10. AE: - inc AST/ALT -BLEEDING -Necrosis/gangreen -anorexia N/V/D -Rash CONSIDERATIONS: -LONG HALF LIFE + DURATION!!!! -balanced diet LOW IN LEAFY GREEN VEG CONTAINING VIT K!!!! -INR CHECKS -AVOID INJURY!!! CALL IF YOU FALL!!!! INTERACTIONS: bleeds: ASA, NSAIDS, H2 blockers, erythromycin, cefoxitin, disulfiram, amiodarone, thyroid drugs, cotrimoxazole dec coag: Vitamin K & E, rifampin, phenytoin, barbiturates, prednisone, omeprazole Antiplatelets - ANSWER inhibit platelet aggregation Aspirin - ANSWER Indications: - MI BITE AND CHEW! -CVA (tx or prophyl) -CAD (prophyl) - used within 48 hours of stroke -before and after endarterectomy MOA: -inhibit platelet aggregation by interfering w/ thromboxane A2 SE: tinnitus/bleeding AE: N, dyspepsia, heartburn, gi bleed, toxicity, headache, anaphylactoid reaction CONSIDERATIONS: -DISCONTINUE 1WK PRIOR SURGERY -NO ANTIDOTE!!!! Clopidogrel (Plavix) - ANSWER MOA: -prevent platelet aggregation AE: - similar SE/AE as aspirin + FLU LIKE SYMPTOMS + NOSEBLEEDS - thrombocytopenia, aplastic anemia, agranulocytosis Considerations: - pt allergic to aspirin can take clopidogrel!!! - ONSET IS SEVERAL DAYS AND DRUG EFFECTS LAST 7 DAYS Rivaroxaban (Xarelto) - ANSWER Anticoagulant, Factor Xa Inhibitor indications: - DVT /PE PROPHYLAXIS - prophyl for pts going into hip/knee surgery AE: bleeding CONSIDERATIONS: -does not require routine coag monitoring -administered once daily or twice a day P.O. -monitor for spinal epidural hematoma -avoid concomitant use w/ other blood thinners -no reversal agent ANTICOAG CONTRAINDICATIONS - ANSWER •Bleeding disorders •Peptic ulcer •Severe hepatic or renal disease •Hemophilia •CVA •Eye, brain, or spinal surgery •Risk for injury from fall •Concomitant use with other anticoagulants • ANTICOAG NURSING PROCESS - ANSWER Assessment •Hx clotting or bleeding •Drug & herb use •Baseline labs: CBC, Coags, LFTs, renal labs •Heparin: aPTT or Factor Xa •Warfarin: INR • Diagnoses •Risk for injury (bleeding) •Knowledge deficit Evaluation aPTT, Factor Xa, INR are within therapeutic range • Anticoagulants: Nursing Care - ANSWER •Use soft toothbrush, electric razor, ID bracelet •Observe the "Rs" of safe med admin. Esp. the right "REASON" •Assess for allergies and hx of HIT •Assess for S/S of bleeding, thrombosis, and embolism •Current medication regimen including OTC (Ginkgo, garlic, ginseng = increase bleeding with warfarin) •Increase effect = NSAIDs, acetaminophen, PCN, Prilosec •Check for baseline INR, PT, aPTT, CBC (platelet) •Do not give IM injections of any drugs •Discontinue 3-7 days before surgery (discuss with provider) • THROMBOLYTICS- alteplase - ANSWER INDICATIONS: - MI w/i 1 HOUR -thromboembolic STROKE W/I 4.5 HR -PE/DVT/non coronary arterial occlusion d/t thromboembolism and to restore patency of central lines MOA: -Promote fibrinolytic mechanism -Convert plasminogen to plasmin to dissolve clot SE: bleeding AE: intracerebral hem, stroke, dysrhythmia CONSIDERATIONS: - basline vitals, cbc, pc, inr, ptt - MONITOR NEURO STATUS!!!!! Antilipemics- statins - ANSWER EEATORVASTATIN INDICATIONS: - dec r4 MI / strokein pts w/ type 2 diabetes - reduce elevated total C levels, inc HDL -8 YRS OLD + MOA: - HMG-CoA = precursor to cholest synth. Statin inhibits enzyme HMG CoA = dec LDL INC HDL AE: - nasopharyngitis -arthralgia -diarrhea -UTI -myalgia -photosense/cataracts -Skel musc issues (myopathay / rhabdomyolisis) CONSIDERATIONS: - mon liv enzymes