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Jake Shared "B4 PHARM2" - 39 Picmonics

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B4 PHARM2

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
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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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
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2 mins
Heparin Indications
Indications
Acute Coronary Syndrome (ACS)
Prophylaxis
Pulmonary Embolism
Atrial Fibrillation
Used during Pregnancy
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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
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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
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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
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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
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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
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
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
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
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2 mins
Coagulation Cascade Overview
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
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
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2 mins
Systemic Effects of Beta-Blockers
Respiratory
Bronchoconstriction
Metabolic
Decreased Insulin
Decreased Glycolysis and Lipolysis
Eye
Reduces Intraocular Pressure
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1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Nonselective Beta-Blockers
"-olol" Suffix
Nonselective
Propranolol
Timolol
Nadolol
Partial β Agonist
Pindolol
Nonselective β with α Blocking
Carvedilol
Labetalol
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2 mins
Selective Beta-1 Blockers
Characteristics
"-olol" Suffix
Drug Names
Beta-1 Selective
Atenolol
Esmolol
Metoprolol
Partial Beta agonists
Acebutolol
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1 min
Class I Antiarrhythmics (Na+ Channel Blockers) Overview
Indications
Arrhythmias
Local Anesthesia
Mechanism of Action
Block or Slow Conduction
Block Na+ Channels
Raise Threshold
State Dependent
Contraindication
Hyperkalemia
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1 min
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
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1 min

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