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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018
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Antithrombotic Agents

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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018 | Registered Nurse (RN) School Study Aid

Antithrombotic Agents
13 Picmonics to Learn | 23 mins
Coagulation Cascade
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
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2 mins
Heparin (Unfractionated)
Mechanism of Action
Suppresses Coagulation
Indications
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Side Effects
Hemorrhage
Heparin-Induced Thrombocytopenia (HIT)
Considerations
Monitor aPTT
Preferred (Safe) During Pregnancy
Antidote
Protamine Sulfate
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2 mins
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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59 secs
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
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2 mins
Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)
Mechanism
IIb/IIIa Receptor Inhibitors
Inhibits Platelet Aggregation
Indications
Thrombotic Event Prevention
Acute Coronary Syndrome (ACS)
Percutaneous Coronary Intervention (PCI)
Side Effects
Bleeding
Considerations
Expensive
Combination Drug Therapy
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2 mins
Ticlopidine (Ticlid)
Mechanism
ADP Receptor Antagonist
Irreversibly Inhibits Platelet Aggregation
Indications
Thrombotic Event Prevention
Side Effects
Neutropenia
Thrombotic Thrombocytopenic Purpura (TTP)
GI Distress
Rash
Considerations
Withhold Before Surgery
Monitor Blood Count
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2 mins
Clopidogrel (Plavix)
Mechanism
ADP Receptor Antagonist
Prevent Platelet Aggregation
Indications
Acute Coronary Syndrome (ACS)
Prevention of Thrombotic Events
Side Effects
Bleeding
Thrombotic Thrombocytopenic Purpura (TTP)
Pancytopenia
Abdominal Pain
Considerations
Withhold Before Surgery
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2 mins
Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
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2 mins
Alteplase
Mechanism
Tissue Plasminogen Activator
Indications
Thrombosis
Side Effects
Bleeding
Contraindications
Intracranial Hemorrhage
Internal Hemorrhaging
Considerations
Minimize Bleeding
Monitor for Shock
Antidote
Aminocaproic Acid
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2 mins

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