Questions and Answers
What is the difference between anticoagulants and antiplatelets?
What should a nurse check before administering aspirin?
What is the prototype drug for long-acting inhalers?
What is the suffix for glucocorticoids?
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What is the prototype medication for methylxanthines?
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What is the therapeutic range for theophylline?
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What occurs first in the formation of a blood clot?
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What should a patient be instructed to do after using an inhaler?
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What is the oxygen saturation level at which a patient with MI would be indicated for oxygen therapy?
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What are the side effects of inhaled steroids?
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What is the mechanism of action of montelukast?
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What is the purpose of inhaled steroids?
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How long does it take to see the full benefits of montelukast?
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How should a patient use an inhaler?
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What is a side effect of inhaled steroids?
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What medication is used to treat oral thrush resulting from inhaled steroid use?
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What is the MOA of leukotriene modifiers like Montelukast?
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What is the main difference between Ipratropium and Tiotropium?
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What is the MOA of anticoagulants like Heparin and Warfarin?
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What is the correct order of treatment for a patient with a myocardial infarction?
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What is the primary focus of treating asthma?
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What type of medication is Salmeterol?
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What is the MOA of Theophylline?
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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.
