MT3II: DRUGS FOR BLOOD COAGULATION

• Enoxaparin 


  is a low molecular weight heparin that does not is a low molecular weight heparin that does not need intense monitoring.
• What is the primary function of hemostasis?

  To stop blood flow and protect the body from injury
• Why is efficient hemostasis crucial for survival?

  It prevents excessive bleeding that could lead to shock or death
• What is the nature of the hemostasis process?

  It involves a series of clotting factors activated in a cascade
• What can result from excessive clotting?

  It can lead to dangerous conditions such as thrombosis
• Name two diseases that can affect hemostasis.

  Myocardial infarction (MI) and cerebrovascular accident (CVA)
• What does hemostasis achieve in the body?

  It forms a blood clot to protect against excessive hemorrhage
• What is the consequence of a clot restricting blood flow?

  It necessitates the restoration of circulation for normal tissue function
• What is the process of clot removal called?

  Fibrinolysis
• When does fibrinolysis begin after clot formation?

  Within 24 to 48 hours
• What are the two main categories of disorders affecting coagulation?

  1. Thromboembolic disorders (overproduction of clots)
  2. Hemorrhagic disorders (ineffective clotting process)
• What are the three major groups of drugs used for coagulation disorders?

  Anticoagulants, antiplatelet, and thrombolytics
• What is the primary action of anticoagulants?

  To prolong bleeding time and prevent blood clots from forming
• Why are anticoagulants also called blood thinners?

  Because they prevent the formation of new clots
• In which patients are anticoagulants typically used?

  Patients with venous and arterial disorders at high risk for clot formation
• What are some venous problems treated with anticoagulants?

  Thrombosis and pulmonary embolism
• What are some arterial problems treated with anticoagulants?

  Coronary thrombosis and myocardial infarction (MI)
• When are anticoagulants contraindicated?

  In cases of active bleeding, except for certain conditions
• What are some side effects of anticoagulants?

  Hemorrhage, hematuria, and bleeding gums
• What is warfarin (Coumadin) used for?

  To interfere with the formation of vitamin K-dependent clotting factors
• What is the role of vitamin K in relation to warfarin?

  Vitamin K is used to reverse the effects of warfarin
• What are the normal and therapeutic lab values for Prothrombin Time (PT)?

  Normal: 11-12.5 seconds; Therapeutic: 15.5-35 seconds
• What are the normal and therapeutic lab values for International Normalized Ratio (INR)?

  Normal: 0.8-1.1; Therapeutic: 2-3
• What does a longer than normal PT indicate?


  It may indicate a lack of clotting factors or vitamin K
• What can cause a longer than normal PT?

  Conditions like liver disease, vitamin K deficiency, or DIC
• What is the action of Dabigatran (Pradaxa)?

  It directly inhibits thrombin, blocking clot formation
• What is the action of Rivaroxaban (Xarelto)?

  It is a factor Xa inhibitor that stops the coagulation cascade
• What is the mechanism of action of heparin?

  It inhibits the conversion of prothrombin to thrombin
• How is heparin administered?

  Injected IV or subcutaneously
• What is the onset of action for heparin?

  It has an immediate onset of action
• What is the advantage of low molecular weight heparin like Enoxaparin?


  It requires less intense monitoring than regular heparin
• What is the antidote for heparin overdose?

  Protamine sulfate
• What does the activated partial thromboplastin time (aPTT) test evaluate?

  It assesses the ability to form blood clots
• What are the normal and therapeutic lab values for aPTT?

  Normal: 30-40 seconds; Therapeutic: 45-100 seconds
• What are the nursing implementations for evaluating anticoagulant therapy?

  1. Monitor PT for warfarin (1.5 to 2.5 times control)
  2. Monitor aPTT for heparin (1.5 to 3 times control)
  3. Check for signs of blood loss (petechiae, bruises)
  4. Implement safety measures to reduce bleeding risk
  5. Increase precautions during invasive procedures
• What are the indications for thrombolytic medications?

  • Acute myocardial infarction
  • Pulmonary embolism
  • Acute ischemic cerebrovascular accident (CVA)
  • Deep vein thrombosis (DVT)
• What is the goal of thrombolytic therapy?

  To quickly restore blood flow to the tissue served by the blocked vessel
• What are the contraindications for thrombolytic medications?

  Active internal bleeding, history of CVA, and recent trauma
• How does timely administration of thrombolytics affect ischemic stroke?

  It significantly improves clinical outcomes if given within 3 hours
• What are some adverse effects of thrombolytic medications?

  Bleeding complications including GI and cerebral hemorrhages