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Pharm final

What is the mode of actions of heparin? All of them! Like before you have a clot, once it's forming and in regards to platelets!
Heparin binds to antithrombin III, and inhibits factors 9,10,11,12 . This blocks prothrombin to thrombinconversion. If the clot is already starting to form, heparin blocks conversion of fibrinogen to fibrin, block clotting factor 13. It can also block clotting factors 5 and 8 and inhibit platelet aggregation
 
What drug is used to prevent DVT, PE, and DIC?
Heparin
 
What are some adverse effects for heparin?
Bleeding, HIT, pain in the injection area and redness
 
Heparin can be given orally, but you just need to rotate sites. T OR F
False, heparin is only SUBQ and IV
 
What is apTT? And when should this be administer for heparin?
This is the activated partial thromboplastin time. It is to measure the time it takes for the body to make clotting factors usually is 23-35 but for a person at risk for blood clots should be 1.5 to 2.5 times that so about 45-70 . It is taken ONE hour before administration
 
Protamine is the antidote for?
Heparin
 
What is the action of warfarin?
Warfarin competes with vitamin K and prevents the synthesis of vitamin K dependent factors like 2,7,9,10.
 
How long does heparin take to work?
3-5 days, it is long term
 
The patient asks you how you are going to administer warfarin...what do you tell them?
Orally!
 
Adverse effects for heparin name them!
Bleeding, NV, abdominal cramping, ALOPECIA, uticaria, dizziness, joint/ muscle pain
 
Contraindications for anticoagulants?
Bleeding disorders!
 
BBW for warfarin
Major fatal bleeding
 
Antidote for warfarin
Vitamin K
 
How often should you check the PT test for warfarin?
Every day then every 2 to 4 weeks, or more often if dosage changes
 
What factor does rivaroxaban inhibit?
Factor Xa
 
What drug is taken for TKR and THR?
Rivaroxaban
 
Syncope, blisters, pruritus, muscle spasm, bleeding are side effects of?
Rivaxoban
 
What is important to t4ell the patient taking warfarin as far as diet? HINT veggies
Do not change diet of vitamin K.
 
Meds that DISSOLVE blood clots are
Thrombolytic agents
 
What are the 3 ANTICOAGULANTS we have learned?
Heparin, warfarin, and rivaxoban
 
What is the antiplate we have learned?
Clopidogrel
 
What is the BBW for clopidogrel
Genetic poor metabolizer of drug = poor effects= chances of getting MI
 
What is the the medication that blocks ADP receptors on the platelet cell membranes
Clopidogrel
 
What clopidogrel used for?
Reduction of MI, stroke, vascular death in patients with atherosclorosis.
 
How often do you give clopidogrel
Once every day
 
What are the two dyslipidemic drugs?
Atorvastatin and Fenofibrate
 
What drug is most powerful for LDL
Atorvastatin
 
What are some adverse effects of atorvastatin?
Myopathy, rhambodomyosis, abdominal cramps or pain, headache
 
What time should the patient take atorvastatin
At night
 
What is the action of atorvastatin
Inhibit enzyme HMG, CoA required for hepatic synthesis
 
What does fenofibrate do?
Oxidation of fatty acids
 
Gallstones are a side effect of what drug
Fenofibrate
 
What drug is most effective with the reduction of tryglycerides
Fenofibrate
 
What test do you need to do before adminestering dislipidemic drugs
Liver function tests
 
What are the 3 Antihypertensive drugs?
Captopril, losartan, aliskerin
 
What is the action of captopril?
Block enzyme that converts angiotensin I to angiotensin II, decreasing vasoconstriction. This enzyme also reduces bradykinin, a potent constrictor so vasodilation is prolonged. Also decreases aldosterone production and and retention of water and salt is decreased.
 
Uses of this drug include hyoertension with diabetes. Decreases the progression of renal retinopathy. Decreases protenuria and decreases kidney impairment. This also prevents cardiac remodeling... What drug is this?
Captopril
 
This drug (captopril) is taken alone in what kind of people?
White
 
African americans take this drug for hypertension, most likely combined with other meds...
Captopril
 
What are the common adverse effects of captopril
COUGH, hypotension, hyperkalemia
 
What are the serious adverse effects of captopril?
Neutropenia, ANGIOEDEMA, agrunolocytosis, protenuriria
 
How do you administer captopril?
PO on empty stomach!!!!
 
What happens if you stop taking captopril, suddenly??
Risk of MI and stroke
 
What are some patient teachings, GO!
Take BP at the same time, and record it. You might experience dizziness, so plan accordingly. Report sore throat, chest tightness, dyspenea, eyelid and lip swelling.
 
This drug blocks the vasocontriction and aldosterone effects of Angiotensin II, and prevents angiotensin II from combining at various sites. It also increases renal BF and enhances secretion of chloride, calcium, magnesium and phosphate.
Losartan!
 
What drug do you used for hypertension in patients with type 2DM, with diabetic nephropathy
Losartan
 
What are some adverse effects of lorsatan
Loss of sensation, angioedema, dizziness, muscle cramps, weakness, heart burn and diarrhea
 
What is the BBW for losartan and captopril?
Injury and death to fetus
 
When taking losartan nurse constantly checks
Liver, kidney function and potassium levels
 
Patient teaching for losartan
Use BC meauseres, contact doctor immediately if prego or lactating. Do not take any K supplements or salt subs containing potaaium
 
What drug is the only renin inhibitor
Aliskerin
 
What conversion does aliskerin block
Blocks angiotensinogen to angiotensin I
 
What are some adverse effects of aliskerin?
Cough, hypotension, edema, diarrhea, INCREASED URIC ACID AND KIDNEY STONES. angioedema
 
Who should NOT take aliskerin
People with diabetes ALREADY takiing ACE OR ARB inhibior!
 
What does the nurse have to do behore administering aliskerin in a patient with fluid imbalances?
CORRECT IT!
 
What should the nurse keep checking with aliskerin
BP, renal function and electrolytes
 
What drug is a nasal decogenstant
Pseudoephrine
 
What does pseudoephrine do
It acts on the adrenergic receptors and releases noreepinephirne from storage. It produces vasocontriction, which shrinks nasalmucosa membranes
 
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