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What is the role of anticoagulants?
What is the role of anticoagulants?
What are the two types of Heparin mentioned in the text?
What are the two types of Heparin mentioned in the text?
Which drug is used to break down (lyse) existing clots?
Which drug is used to break down (lyse) existing clots?
What is the purpose of Antiplatelets?
What is the purpose of Antiplatelets?
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Why do we need to frequently draw aPTT for a patient on unfractionated heparin?
Why do we need to frequently draw aPTT for a patient on unfractionated heparin?
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What is the antidote for Heparin?
What is the antidote for Heparin?
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Which of the following is a side effect of warfarin use?
Which of the following is a side effect of warfarin use?
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What is the treatment for Heparin-induced Thrombocytopenia (HIT)?
What is the treatment for Heparin-induced Thrombocytopenia (HIT)?
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What should be checked in patients with Heparin-induced Thrombocytopenia (HIT)?
What should be checked in patients with Heparin-induced Thrombocytopenia (HIT)?
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What is the role of Aspirin in preventing platelet adhesion?
What is the role of Aspirin in preventing platelet adhesion?
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What is the purpose of bridge therapy mentioned in the text?
What is the purpose of bridge therapy mentioned in the text?
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What is the complication caused by Heparin that results in decreased platelets in the blood?
What is the complication caused by Heparin that results in decreased platelets in the blood?
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Match
Match
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The antidote to Warfarin
The antidote to Warfarin
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To monitor Vitamin K level we need to run
To monitor Vitamin K level we need to run
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With Low molecular weight heparin (LMWH) , make sure you monitor aPTT frequently.
With Low molecular weight heparin (LMWH) , make sure you monitor aPTT frequently.
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Two LMHW heparins are Enoxaparin/Lovenox and Dalteparin/Fragmin.
Two LMHW heparins are Enoxaparin/Lovenox and Dalteparin/Fragmin.
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Patients taking warfarin need to be education on safe administration, bleeding management and prevention, and when to contact their doctor.
Patients taking warfarin need to be education on safe administration, bleeding management and prevention, and when to contact their doctor.
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What is the antidote for dabigatran and how does it work?
What is the antidote for dabigatran and how does it work?
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When giving vitamin K, what is the risk associated with its intravenous administration?
When giving vitamin K, what is the risk associated with its intravenous administration?
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In the context of anticoagulant medications, what is the purpose of bridge therapy?
In the context of anticoagulant medications, what is the purpose of bridge therapy?
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What is the normal INR without warfarin, and how does it change with warfarin?
What is the normal INR without warfarin, and how does it change with warfarin?
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What is the antidote for dabigatran?
What is the antidote for dabigatran?
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Which medication is commonly prescribed as an oral anticoagulant and requires monitoring of PT/INR?
Which medication is commonly prescribed as an oral anticoagulant and requires monitoring of PT/INR?
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Which medication should not be given for at least 6-8 hours after surgery, as per the text?
Which medication should not be given for at least 6-8 hours after surgery, as per the text?
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What is the recommended route of administration for Argatroban?
What is the recommended route of administration for Argatroban?
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What should be checked in patients with Heparin-induced Thrombocytopenia (HIT)?
What should be checked in patients with Heparin-induced Thrombocytopenia (HIT)?
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What is the purpose of Antiplatelet medications mentioned in the text?
What is the purpose of Antiplatelet medications mentioned in the text?
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What is the most commonly prescribed oral anticoagulant that requires measurement of PT/INR?
What is the most commonly prescribed oral anticoagulant that requires measurement of PT/INR?
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Which anticoagulation medication should not be given consistently with a patient's intake of vitamin K and should be avoided with grapefruit or cranberry juice?
Which anticoagulation medication should not be given consistently with a patient's intake of vitamin K and should be avoided with grapefruit or cranberry juice?
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What is the recommended route of administration for Heparin when used therapeutically?
What is the recommended route of administration for Heparin when used therapeutically?
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Which drug is an oral thrombin inhibitor and its dose is dependent on renal function?
Which drug is an oral thrombin inhibitor and its dose is dependent on renal function?
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What is the antifibrinolytic drug given immediately after symptoms of a MI or Stroke?
What is the antifibrinolytic drug given immediately after symptoms of a MI or Stroke?
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What is the recommended action when two anticoagulation medications are ordered, as per the text?
What is the recommended action when two anticoagulation medications are ordered, as per the text?
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Why should Enoxaparin/Lovenox be administered without expelling air bubbles from the prefilled syringe, according to the text?
Why should Enoxaparin/Lovenox be administered without expelling air bubbles from the prefilled syringe, according to the text?
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When giving Vitamin K, Warfarin resistance will occur for up to ____ days.
When giving Vitamin K, Warfarin resistance will occur for up to ____ days.
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Three antiplatelet medications are Aspirin, Plavix, Integrilin
Three antiplatelet medications are Aspirin, Plavix, Integrilin
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Study Notes
Anticoagulants and Their Role
- Anticoagulants prevent blood clot formation, reducing the risk of thrombosis and embolism.
- Two types of Heparin: Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH).
- Common LMWHs include Enoxaparin (Lovenox) and Dalteparin (Fragmin).
- Thrombolytic agents like alteplase are used to break down existing clots.
Antiplatelet Medications
- Antiplatelets prevent platelet aggregation, which helps reduce the risk of arterial thrombosis.
- Common antiplatelet medications include Aspirin, Plavix, and Integrilin.
Monitoring and Adjustments
- Activated Partial Thromboplastin Time (aPTT) is monitored frequently in patients on Unfractionated Heparin to ensure therapeutic levels and prevent bleeding complications.
- The normal International Normalized Ratio (INR) is around 1.0, which increases with warfarin therapy, targeting therapeutic levels between 2-3 or higher in certain conditions.
Antidotes and Treatments
- Antidote for Heparin: Protamine Sulfate.
- Antidote for Warfarin: Vitamin K administration; can result in resistance for up to seven days.
- Antidote for Dabigatran: Idarucizumab, acts by binding to the drug and neutralizing its effect.
- Treatment for Heparin-induced Thrombocytopenia (HIT): Direct thrombin inhibitors like Argatroban.
Considerations in Therapy
- Patients on warfarin require education on proper use, potential bleeding risks, and the need for routine INR monitoring.
- Vitamin K must be administered cautiously due to the risk of anaphylactic reactions, especially with intravenous administration.
- Patients with HIT should have platelet counts closely monitored due to the risk of thrombosis despite low platelet numbers.
Therapeutic Use and Administration
- Heparin is given via subcutaneous or intravenous routes; the intravenous method is used for rapid therapeutic effects.
- Enoxaparin should be administered without expelling air bubbles from the prefilled syringe to avoid dosing errors and ensure full medication delivery.
- Bridge therapy involves the temporary use of short-acting anticoagulants to maintain anticoagulation during transitions to or from warfarin.
Contraindications and Side Effects
- Avoid LMWH in patients with severe renal impairment, as dosage adjustments may be necessary.
- Warfarin should not be used consistently with high Vitamin K intake or harmful interactions with grapefruit or cranberry juice.
- Common side effects of warfarin include bleeding complications and interactions with other medications.
Emergencies and Treatments
- Antifibrinolytic drug administered immediately after myocardial infarction (MI) or stroke symptoms helps stabilize clots.
- The recommended action when two anticoagulant medications are ordered is to assess for potential interactions and overlapping effects to prevent excessive anticoagulation.
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Description
Test your knowledge of the fibrinolytic system, anticoagulants, antiplatelets, hemorheologic drugs and thrombolytic drugs. Learn about medications that slow blood clotting, prevent clot formation and keep platelets from sticking together.
