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Antiplatelet Drugs
ASA Acetyl Salicylic Acid
- Inhibits PLT aggregation by inhibiting PLT symthesis.
- GI Bleed, tinnitus, hearing loss, anaphylaxis. Acute ASA toxicity=hyperpnea, fever, coma, death.
- Check for allergies. Monitor daily dosages (watch for toxicity). Check for use of other products that contain ASA (OTC).
- Reduction of TIA or strokes, reduce risk of death after MI when past hx of MI..
- Inhibits platelet adhesion and aggregation by blocking receptor sites on the platelet membrane
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Coumarin Anticoagulants
Warfarin (Coumadin)
- Antagonize Vitamin K, which blocks Vitamin K dependent factors
- Preganacy Cat. X. Abdominal cramps.
- PO used most widely. Interact with MANY drugs.
- A-Fib, DVT, PE, MI, TIA, rheumatic heart. Prophylaxis after valves, immobilization, or major surgery.
- Interfers with the normal cascade of events involved in the clotting process.
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Natural Anticoagulant
Heparin
- Short onset and short duration of action. Works on antithrombin III
- Thrombocytopenia.
- IV or SC. Increased risk of bleeding if combined with oral anticoagulants, salicylates, PCN, or cephalosporins. Decrease in anticoagulation with NTG.
- Prevent thrombus formation or extension of existing clot. Used in DVT, PE, DIC, MI, and after CABG.
- Inhibits the conversion of prothrombin to thrombin thus blocking the conversion of fibrogen to fibron
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Low-molecular-weight heparins
Enoxaparin (Lovenox)
- Less able to inactivate thrombin, than Heparin. Thus, can use fixed dosing and less lab monitoring than Heparin.
- Thrombocytopenia less frequent. Thrombosis erythemia or pain at injection site.
- SC route only ("LOVEHANDLES")
- Prophylaxis of DVT after orthopedic or abdominal surgery. Unstable angina.
- Inhibit Thrombus and clot formation by blocking Xa and 11a
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Thrombolytic Agents
urokinase (Abbokinase)
- Activates the natural anticlotting system by converting plasminogen to plasmin. This breaks down fibrin that forms the clot.
- Bleeding. Monitor for cardiac arrhythmias and hypotension. Anaphylaxis.
- IV route and cleased from body after liver metabolism. To disolve an already existing clot.
- MI, PE, Iscemic stroke.
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