1
NRS. 212
Pharmacology Final
Exam Study Guide
Anticoagulants, GI, Antimicrobials, Generic Endings 2026 version
Anticoagulants, Antiplatelets, and Thrombolytics Coagulation
Overview
• Hemostasis
o Stage 1: Platelet plug formation
o Stage 2: Coagulation (intrinsic & extrinsic pathways)
• Thrombosis:
o Arterial (rich in platelets, causes stroke/MI)
o Venous (rich in fibrin, causes DVT/PE)
Drug Classes Overview
rug Class Summaries
Drug Class Action Key Drugs Risk Antidote
Heparin, Warfarin, Protamine
Inhibit clotting
Anticoagulants Lovenox, Eliquis, Hemorrhage (Heparin), Vit K
factors
Pradaxa (Warfarin)
Inhibit platelet GI Bleed,
Antiplatelets Aspirin, Clopidogrel None (supportive)
aggregation Hemorrhagic stroke
Severe bleeding,
Dissolve fibrin Amicar
Thrombolytics Alteplase (tPA) Intracranial
clots (Aminocaproic Acid)
Hemorrhage
^` Monitoring Parameters
• Heparin: Monitor aPTT (goal: 60–80 sec); Antidote: Protamine sulfate
• Warfarin: Monitor PT/INR (goal INR: 2.0–3.0); Antidote: Vitamin K
,2
• LMW Heparins (e.g., Enoxaparin): No routine monitoring; SubQ administration
▲` Key Nursing Considerations
_
'
·
´
• Baseline labs: CBC, aPTT, PT/INR
• Watch for signs of bleeding: hematuria, melena, bruising
• Antidotes ready: Protamine (Heparin), Vitamin K (Warfarin)
• Drug interactions: Warfarin and aspirin increase bleeding risk
• Patient education: Avoid high vitamin K foods (warfarin), use electric razors, soft
toothbrush
. Signs and Symptoms of Bleeding
ı
• Bruising (ecchymosis)
• Bleeding gums
• Hematuria (blood in urine)
• Melena (black, tarry stool)
• Epistaxis (nosebleeds)
• Hemoptysis (coughing blood)
• Low BP, high HR, dizziness, pallor (late signs of hemorrhage)
*¿· Foods High in Vitamin K (↓ warfarin effect)
×<•`
˙˘´
• Leafy greens: kale, spinach, collards, turnip greens
• Broccoli
• Brussels sprouts
• Cabbage
• Green tea
• Mayonnaise (soy/canola oil)
Teach patients on warfarin to eat consistent amounts—not avoid entirely.
, 3
Interventions to Prevent Bleeding
• Use electric razors instead of blades
• Use soft-bristle toothbrush
• Avoid contact sports and injury-prone activities
• Avoid IM injections unless necessary
• Monitor CBC, stool for occult blood
• Avoid concurrent use of NSAIDs, aspirin, or alcohol unless prescribed
• Apply pressure to venipuncture sites for ≥5 minutes
• Have antidotes readily available before starting therapy
, Patient Education
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• Notify provider of unusual bleeding/bruising
• Wear a medical alert bracelet
• Take meds at the same time daily
• Inform all providers/dentists about anticoagulant use
• Do not double-dose if a dose is missed (warfarin)
Review Nursing Considerations:
Heparin (Unfractionated)
• Nursing Considerations:
o Monitor aPTT (goal: 60–80 seconds).
o Use infusion pump for IV administration.
o Antidote: Protamine sulfate—have available on unit.
o Monitor for signs of bleeding (gums, urine, stool).
o Assess for heparin-induced thrombocytopenia (HIT)—monitor platelets.
NRS. 212
Pharmacology Final
Exam Study Guide
Anticoagulants, GI, Antimicrobials, Generic Endings 2026 version
Anticoagulants, Antiplatelets, and Thrombolytics Coagulation
Overview
• Hemostasis
o Stage 1: Platelet plug formation
o Stage 2: Coagulation (intrinsic & extrinsic pathways)
• Thrombosis:
o Arterial (rich in platelets, causes stroke/MI)
o Venous (rich in fibrin, causes DVT/PE)
Drug Classes Overview
rug Class Summaries
Drug Class Action Key Drugs Risk Antidote
Heparin, Warfarin, Protamine
Inhibit clotting
Anticoagulants Lovenox, Eliquis, Hemorrhage (Heparin), Vit K
factors
Pradaxa (Warfarin)
Inhibit platelet GI Bleed,
Antiplatelets Aspirin, Clopidogrel None (supportive)
aggregation Hemorrhagic stroke
Severe bleeding,
Dissolve fibrin Amicar
Thrombolytics Alteplase (tPA) Intracranial
clots (Aminocaproic Acid)
Hemorrhage
^` Monitoring Parameters
• Heparin: Monitor aPTT (goal: 60–80 sec); Antidote: Protamine sulfate
• Warfarin: Monitor PT/INR (goal INR: 2.0–3.0); Antidote: Vitamin K
,2
• LMW Heparins (e.g., Enoxaparin): No routine monitoring; SubQ administration
▲` Key Nursing Considerations
_
'
·
´
• Baseline labs: CBC, aPTT, PT/INR
• Watch for signs of bleeding: hematuria, melena, bruising
• Antidotes ready: Protamine (Heparin), Vitamin K (Warfarin)
• Drug interactions: Warfarin and aspirin increase bleeding risk
• Patient education: Avoid high vitamin K foods (warfarin), use electric razors, soft
toothbrush
. Signs and Symptoms of Bleeding
ı
• Bruising (ecchymosis)
• Bleeding gums
• Hematuria (blood in urine)
• Melena (black, tarry stool)
• Epistaxis (nosebleeds)
• Hemoptysis (coughing blood)
• Low BP, high HR, dizziness, pallor (late signs of hemorrhage)
*¿· Foods High in Vitamin K (↓ warfarin effect)
×<•`
˙˘´
• Leafy greens: kale, spinach, collards, turnip greens
• Broccoli
• Brussels sprouts
• Cabbage
• Green tea
• Mayonnaise (soy/canola oil)
Teach patients on warfarin to eat consistent amounts—not avoid entirely.
, 3
Interventions to Prevent Bleeding
• Use electric razors instead of blades
• Use soft-bristle toothbrush
• Avoid contact sports and injury-prone activities
• Avoid IM injections unless necessary
• Monitor CBC, stool for occult blood
• Avoid concurrent use of NSAIDs, aspirin, or alcohol unless prescribed
• Apply pressure to venipuncture sites for ≥5 minutes
• Have antidotes readily available before starting therapy
, Patient Education
-̇
¡
•
˙˜
*
ˆ
^
T
u
r
µ
.
.̇
• Notify provider of unusual bleeding/bruising
• Wear a medical alert bracelet
• Take meds at the same time daily
• Inform all providers/dentists about anticoagulant use
• Do not double-dose if a dose is missed (warfarin)
Review Nursing Considerations:
Heparin (Unfractionated)
• Nursing Considerations:
o Monitor aPTT (goal: 60–80 seconds).
o Use infusion pump for IV administration.
o Antidote: Protamine sulfate—have available on unit.
o Monitor for signs of bleeding (gums, urine, stool).
o Assess for heparin-induced thrombocytopenia (HIT)—monitor platelets.
