Chapter 55 Pharm

reduce the formation of fibrin = big role in clot development

class: anticoagulant
administered by injection only IV or deep sub q
use: perferred anticoagulation during pregnancy and rapid anticoagulation is required, massive DVT, renal dialysis, postop
adverse: hemorrhage, heparin-induced thrombocytopenia (wipes out platelets)
antidote for OD: protamine sulfate
activated partial thromboplastin time (aPTT) = every 6-8 hours drawn to see level and will increase dose or decrease depending
normal aPTT 40 seconds
need to know baseline coagulants before giving someone heparin

subq
dosage based on body weight
does not require monitoring; can be given at home
adverse: bleeding, severe neurologic injury for patients undergoing spinal punctor or spinal epidural anesthesia

class: low-molecular-weight heparin

class: anticoagulant
use: oral anticoagulant with delayed onset, vitamin K antagonist (reverse warfarin)
not useful in emergencies, prevent DVT and associated pulmonary ebolism, prosthetic heart valve = platelets want to attack the valve, atrial fibrillation
monitor prothrombin time (PT) and international normalized ratio (INR)
adverse: hemorrhage, fetal hemorrhage and teratogen from use during pregnancy
vitamin k for overdose
educate patient that you don't want them to eat large amounts of leafy greens or vitamin K rich

uses: acute MI, previous MI, primary prevention of MI
tiny bit antiplatelet coverage
adverse: GI bleeding

class: antiplatelet
uses: prevent blockage of coronary artery stents
similar to adverse effects of aspirin

class: antiplatelet
most effective antiplatelet drugs, "super aspirins"

use: MI, ischemic stroke, PE
adverse: severe bleeding such as intracranial bleeding