Agents that act on the blood

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  1. Anticoagulants
    drugs that prolong the bodys ability to form a thrombus (clot) at different points in the coagulation cycle.
  2. Intrinsic pathway and coagulation
    Caused from peripheral vascular damage
    coagulation inhibited by components entirely contained within the vasculature.
  3. Goal of anticoagulant therapy
    promote anticoagulation while minimizing hemorrhagic complications through careful monitoring.
  4. Heparin MOA

    TEST ????
    no effect on existing clots- prevents formation of new thrombi

    Binds with antithrombin III at two sites, first site has effect on factor x, and second site binding occurs at conversion of prothrombin to thrombin.   TEST ???
  5. Clotting factors have different half lives.
    Which has shortest?
    Factor VII - 6-9 hours

    Factor II and X- up to 72 hours
  6. What is gold standard for monitoring anticoagulant treatment
  7. Dosage of warfarin
    • long half life but narrow therapeutic window
    • begin at 2.5- 5 mg daily

    Range is 1-15 have to individualize dose
  8. Acceptable INR in DVT
  9. INR prevention of recurrent thrombosis
  10. INR with cardiac valve replacement
    • tissue valve 2.0-3.0
    • Mechanical valve 2.5-3.5
  11. INR recurrent systemic embolism
  12. MOA of aspirin (platelet aggregator)
    • inhibits cyclooxygenase in platelets and endothelial cells, preventing synthesis of thromboxane and prostacyclin.
    • -both are potent platelet aggregators and vasoconstrictors.
  13. Hold warfarin if INR is greater than
  14. ASA is used prophylactically to

    decrease incidence of MI/deaths in men > 50 years old. Treat unstable angina, non Q-wave infarction, and acute MI or CV
  15. Monitoring of Warfarin
    • Recommended dose 5-10 mg
    • Decrease dose in elderly, usually in half
    • Monitor INR every 2-3 days until goal is reached, then weekly, then every 2 weeks, then finally monthly when stable dose and stable INR
  16. Warfarin pregnancy category
  17. Heparin preg category
  18. ASA preg category
  19. Most common problem in patients on aspirin taking NSAIDs is
    GI Bleed
Card Set
Agents that act on the blood
pharm midterm fall 2013
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