Nate Shared "Pharm E2 (Anticoagulants/Antiplatelets)" - 16 Picmonics
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Pharm E2 (Anticoagulants/Antiplatelets)
Clotting Overview
- Characteristics
- Endothelial Cells are Damaged
- Platelets Respond to Exposed Collagen and Stick
- Platelets Release Recruiting Factors
- More Platelets are Attracted
- Soluble Fibrinogen Turns to Insoluble Fibrin
- Fibrin Seals the Clot
- Clot Dissolves
- Liver Produces Clotting Factors
2 mins
Aspirin
- Indications
- Fever
- Pain and Headache
- Cardiovascular Disease (CAD)
- Mechanism of Action
- Irreversible inhibition of COX-1 and COX-2
- Suppress Thromboxanes and Prostaglandins
- NSAID
- Side Effects
- Reye's Syndrome
- Tinnitus
- Peptic Ulceration
- Mixed Acidosis/Alkalosis
- Nephropathy
2 mins
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
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
2 mins
TICAGRELOR (Brillinta)-final
- INDICATION: ACS
- Acute Coronary Syndrome (ACS)
- DOSE
- LD: 160 mg
- MD: 90 mg PO BID for 1 year. After l year. give 60 mg BID
- BOXED WARNINGS
- significant/fatal bleeding
- MD doses of aspirin >100 mg reduce the effectiveness of ticagrelor =AVOID. After any initlal aspirin dose, maintenance aspirin dose should n
- CONTRAINDICATIONS
- Active pathological bleed
- History of ICH
- WARNING
- Bleeding risk
- discontinue 5 days prior to elective surgery
- Hepatic impalrment
- SIDE EFFECTS
- Bleeding
- Dyspnea (>10%)
- Increased SCr
- Bradyarrhythmias
- NOTES
- Do not start in patients likely to undergo CABG surgery
- MedGuide
- TABS: can be crushed
- TABS: can be mixed w/ WATER
- TABS: cam be given via NG TUBE
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
2 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
2 mins
Warfarin
- Mechanism of Action
- Interferes with Vitamin K-dependent Clotting Factors
- Extrinsic Pathway
- Bridge with Heparin
- Indications
- Chronic Anticoagulation
- Side Effects
- Bleeding
- Necrosis
- Cytochrome P450
- Contraindications
- Pregnancy
- Antidote
- FFP + Vitamin K
2 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
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
2 mins
Heparin Indications
- Indications
- Acute Coronary Syndrome (ACS)
- Prophylaxis
- Pulmonary Embolism
- Atrial Fibrillation
- Used during Pregnancy
1 min
Heparin Mechanisms
- Mechanism of Action
- Short Half-life
- Antithrombin Activation Cofactor
- Decrease Thrombin, Factor Xa
- Side Effects
- Bleeding
- Heparin Induced Thrombocytopenia (HIT)
- Antidote
- Protamine Sulfate
2 mins
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
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
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
2 mins
Prazosin (Minipress)
- -osin suffix
- Mechanisms
- Selective Alpha-1 Receptor Blocker
- Indications
- Hypertension
- Benign Prostatic Hyperplasia (BPH)
- Nightmares
- Side Effects
- Orthostatic Hypotension
- Tachycardia
- Priapism / Inhibition of Ejaculation
- Nasal Congestion
- Considerations
- First Dose Effect
- Administer at Bedtime
2 mins
