Anticoagulants
Which drugs are anticoagulants?
Heparin
low-molecular weight heparin (enaxoparin) or lovenox
warfarin
dabigatran
what are common antiplatelet drugs?
aspirin
clopidogrel
what are the types of anemia?
anemia related to chronic diseases such as renal failure, cancer, HIV
anemia related to RBC maturation defects such as in iron deficiency anemia, vitamin B12 and folic acid anemias
anemias related to RBC distruction such as in sickle cell anemia and DIC
what is heaprin induced thrombocytopenia and what do we monitor to know when it develops?
low platelet count as a result of heparin administration
increased development of thrombi
stop heparin when platelet count is less than a 100,000
why do some patients need to take antilipemics?
to reduce LDL cholesterol and triglyceride levels in the blood
what are the labs you check when administering heparin IV?
aPTT level and platelets
hematocrit
what is salicylism?
Aspirin toxicity
tinnitus, sweating, headache, dizziness
which medication is administered in anemias related to end-stage renal failure?
what are the antidotes for anticoagulants?
heparin - protamine
warfarin - vitamin K
dabigatran - praxbind
what are common types of antilipemics?
statins
Niacin - vitamin B
how do you administer enaxoparin prefilled syringe SQ injection?
DO NOT expel air buble from syringe
give it deep into subc. in the abdomen
do not aspirate
pinch skin and use 90 degree angle
rotate sites
what are some of the reasons to administer antiplatelets?
prevents platelet aggregation and adhesion at the site of endothelial injury
what other medication must be administered with epoetin alfa to be effective?
iron to be able to produce RBC and hemoglobin
what are therapeutic normals for anticoagulants?
aPTT 1.5-2 times the baseline value (60-80 sec.)
what are some of the side effects of niacin?
hyperglycemia
flushing of the skin
jaundice
what are some of the reasons we give anticoagulants?
prevention of DVT
prevention of further clot formation after
prevents extension of clots in MI, Stroke, pulmonary embolism
what common diseases antiplatelets are used in?
clopidogrel - prevention or post-MI thrombosis
aspirin - prevention of stroke
take iron between meals
what labs do we monitor when administering warfarin?
liver function tests (AST/ALT)
what are common adverse effects of statins?
liver toxicity and myopathy
what are side effects of anticoagulants?
bleeding
hematoma
anemia
what are common adverse effects of antiplatelet drugs?
GI bleeding
bleeding
anemia
how anemias are treated taht are related to excessive RBC destruction?
fluids
blood products
pain medication in sickle cell anemia
does warfarin starts working right away? if not, waht do we do in the mean time?
warfarin reaches therapeutic effect around day 5,
heparin is given in the mean time to prevent clot formation and wararing reaching its therapeutic effect
what are common labs to monitor with statins?
liver function test
CK - muscle damage