Antiplatelet drugs direct thrombin inhibitors action

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ANTIPLATELET DRUGS
DIRECT THROMBIN INHIBITORS Action: prevents conversion of fibrinogen to fibrin Uses: Prophylaxis or treatment of thrombosis complicating HIT, pts undergoing PCI/PTCA Premedication assessment: assess for bleeding, monitor labs, assess for pregnancy Adverse effects: bleeding
Action Work by selectively and reversibly blocking the activity of clotting factor Xa, preventing clot formation Indication Prevention of DVT & acute pulmonary embolism Reduce the risk of stroke & embolism in pts with Afib Adverse effects Bleeding, fever, anemia, nausea, elevated liver enzymes FACTOR XA INHIBITORS
THROMBOLYTICS Actions Stimulate the body’s own clot-dissolving mechanism, converting plasminogen to plasmin  digests fibrin Uses Dissolve clots secondary to acute MI, pulmonary emboli, acute ischemic stroke, deep venous thrombosis
ROLE OF THE NURSE: THROMBOLYTICS Assess for exclusions to therapy Monitor baseline coagulation studies Monitor level of consciousness for symptoms of cerebral hemorrhage Observe for reperfusion arrhythmias Teach patient about increased risk of bleeding
HEMOSTATICS Used to promote the formation of clots Mechanism of action : to prevent fibrin from dissolving Primary use : to promote formation of clots by preventing and treating excessive bleeding from surgical sites Adverse effects : May cause hypercoagulation with concurrent use of estrogen and oral contraceptives
Bleeding disorders caused by genetic deficiencies in specific clotting factors Able to now to synthesize clotting factors individually Hemophilia A Factor VIII Hemophilia B Factor IX HEMOPHILIA PHARMACOTHERAPY
HEMATOPOIESIS Process of blood-cell formation Begins with stem cell in bone marrow Requires B vitamins, vitamin C, copper, iron, and other nutrients Homeostatic control maintained by hormones and growth factors
Hematopoietic DOs Pregnancy Anemias Replacing the deficient substance that is essential to hematopoiesis Important adjunct medications in the treatment of cancer HEMATOPOIETIC DISORDER TREATMENT
Erythropoietin Hormone that stimulates red blood cell production Stimulates the production of hemoglobin Secreted when kidneys sense reduction in oxygen Body experiences hypoxia or hemorrhage Synthetic form Epoetin alfa Treats anemia associated with chronic renal failure or HIV infection Given as an adjunct medication to pt undergoing cancer chemotherapy Given to reduce the need for blood transfusions in surgical patients HEMATOPOIETIC GROWTH FACTORS AND ENHANCERS
Colony Stimulating Factors Leukopoietic growth factors Stimulate the growth and differentiation of one or more types of leukocytes Increases production of new leukocytes but also activates existing WBCs Named according to the types of blood cells they stimulate Used to treat immunosuppressed pts

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