Aspirin and Anticoagulants in Emergency Care
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Questions and Answers

What is the difference between anticoagulants and antiplatelets?

  • Anticoagulants prevent platelet aggregation, while antiplatelets prevent fibrin formation
  • Anticoagulants are used to treat MI, while antiplatelets are used to treat stroke
  • Anticoagulants prevent fibrin formation, while antiplatelets prevent platelet aggregation (correct)
  • Anticoagulants are used to treat stroke, while antiplatelets are used to treat MI

    • What should a nurse check before administering aspirin?

  • Patient's medical history
  • Patient's allergy to aspirin
  • Patient's blood pressure
  • All of the above (correct)

    • What is the prototype drug for long-acting inhalers?

  • Tiotropium
  • Albuterol
  • Ipratropium
  • Salmeterol (correct)

    • What is the suffix for glucocorticoids?

    <p>-one</p> Signup and view all the answers

    What is the prototype medication for methylxanthines?

    <p>Theophylline</p> Signup and view all the answers

    What is the therapeutic range for theophylline?

    <p>8-15 mcg/mL</p> Signup and view all the answers

    What occurs first in the formation of a blood clot?

    <p>Platelet aggregation</p> Signup and view all the answers

    What should a patient be instructed to do after using an inhaler?

    <p>RINSE MOUTH AFTER USE</p> Signup and view all the answers

    What is the oxygen saturation level at which a patient with MI would be indicated for oxygen therapy?

    <p>87%</p> Signup and view all the answers

    What are the side effects of inhaled steroids?

    <p>Weight gain, hyperglycemia, osteoporosis, hypertension, edema, and increased risk of infection</p> Signup and view all the answers

    What is the mechanism of action of montelukast?

    <p>Bind to CysLT1 receptors in the lungs, suppressing the effect of leukotrienes</p> Signup and view all the answers

    What is the purpose of inhaled steroids?

    <p>To prophylactically and maintain control of asthma</p> Signup and view all the answers

    How long does it take to see the full benefits of montelukast?

    <p>3 weeks</p> Signup and view all the answers

    How should a patient use an inhaler?

    <p>Shake it, breathe slowly and deeply, and hold breath for about 10 seconds</p> Signup and view all the answers

    What is a side effect of inhaled steroids?

    <p>Both a and b</p> Signup and view all the answers

    What medication is used to treat oral thrush resulting from inhaled steroid use?

    <p>Clotrimazole</p> Signup and view all the answers

    What is the MOA of leukotriene modifiers like Montelukast?

    <p>Block the receptors of leukotrienes</p> Signup and view all the answers

    What is the main difference between Ipratropium and Tiotropium?

    <p>Ipratropium is short-acting, while Tiotropium is long-acting</p> Signup and view all the answers

    What is the MOA of anticoagulants like Heparin and Warfarin?

    <p>They prevent the formation and expansion of blood clots</p> Signup and view all the answers

    What is the correct order of treatment for a patient with a myocardial infarction?

    <p>Aspirin, oxygen therapy, morphine, reperfusion therapy</p> Signup and view all the answers

    What is the primary focus of treating asthma?

    <p>Reducing inflammation and preventing exacerbations</p> Signup and view all the answers

    What type of medication is Salmeterol?

    <p>Long-acting beta agonist</p> Signup and view all the answers

    What is the MOA of Theophylline?

    <p>Inhibits phosphodiesterase, leading to increased levels of cAMP</p> Signup and view all the answers

    Study Notes

    Aspirin and Anticoagulants

    • Low dose aspirin is 81mg, full dose is 325mg
    • Before administering aspirin, the nurse should check platelet levels
    • Aspirin is classified as an antiplatelet medication, which prevents platelet aggregation, a key step in blood clot formation

    tPA and Reperfusion Therapy

    • tPA breaks down clots in medical emergencies such as ischemic strokes (cerebrovascular accidents)
    • tPA is administered through IV
    • tPA is part of reperfusion therapy, which includes PCI (angioplasty), thrombolytic therapy, and anticoagulation therapy (heparin)

    Labs for Internal Bleeding

    • To test for internal bleeding, labs should include hemoglobin, hematocrit, platelet count, coagulation parameters, and occult blood test

    Reperfusion Therapy for MI

    • Reperfusion therapy for MI includes PCI (angioplasty), thrombolytic therapy (tPA), and anticoagulation therapy (heparin)
    • PCI involves a balloon to open up narrowed or blocked arteries to restore blood flow to the heart muscles
    • The patient will go to the cath lab to get an angioplasty

    aPTT and Anticoagulation

    • Elevated aPTT means the blood is taking longer than usual to clot, indicating the patient is likely taking anticoagulant medications
    • Low aPTT means the blood is clotting faster than usual, and the patient may need anticoagulants
    • Anticoagulants (heparin, LMWHs, warfarin, DOACs) work by interfering with the coagulation cascade, ultimately preventing the formation and expansion of blood clots
    • Antiplatelets (aspirin, P2Y12 inhibitors) prevent platelet aggregation, a key step in blood clot formation

    Algorithm for Myocardial Infarction

    • The algorithm for MI includes:
      • Aspirin 325mg
      • Second antiplatelet (clopidogrel or ticagrelor)
      • Oxygen therapy to treat hypoxia
      • Morphine to treat pain
      • Beta blocker to bring down heart rate
      • Reperfusion therapy (PCI, tPA, heparin) if indicated

    Obstructive Lung Disease

    • Obstructive lung disease includes COPD (chronic bronchitis, emphysema) and asthma
    • Symptoms of obstructive lung disease include wheezing, dyspnea, and cough
    • Medications for obstructive lung disease include bronchodilators and anti-inflammatory medications

    Asthma and COPD Treatment

    • Treating asthma is focused on reducing inflammation and preventing exacerbations, using inhaled corticosteroids, leukotriene modifiers, and biologics
    • Treating COPD is focused on reducing complications and managing symptoms, using short-acting beta agonists (SABAs) and long-acting beta agonists (LABAs)

    Medications

    • Albuterol is a short-acting beta agonist (SABA) inhaled medication (bronchodilator)
    • Salmeterol is a long-acting beta agonist (LABA)
    • Ipratropium and tiotropium are muscarinic antagonists that work to dilate the bronchi
    • Ipratropium is short-acting, while tiotropium is long-acting due to its bulkier aromatic rings in its side chains
    • Montelukast is an oral leukotriene receptor antagonist medication
    • Glucocorticoids include prednisone (oral) and beclomethasone (inhaled)
    • Methylxanthines include theophylline and aminophylline

    Medication Side Effects

    • Inhaled steroids can cause oral thrush, hoarseness, and throat irritation
    • Prednisone can cause weight gain, hyperglycemia, osteoporosis, hypertension, edema, and increased risk of infection
    • Montelukast can cause headache, abdominal pain, and worsening depression

    Leukotriene Modifiers

    • Leukotrienes cause bronchoconstriction, increased vascular permeability, mucus secretion, and recruitment of inflammatory cells
    • Montelukast binds to CysLT1 receptors in the lungs, preventing leukotriene-mediated bronchoconstriction

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    Description

    This quiz covers the administration and effects of aspirin and anticoagulants, including tPA and reperfusion therapy, in medical emergencies such as ischemic strokes.

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