NR 567 SIMPLIFIED AND BRIEF
REVISION SUMMARY
Warfarin
Inhibits vitamin K activation of clotting factors II (prothrombin),
VII, IX, and X formed in the liver.
Protamine Sulfate
Heparin antidote
Vitamin K and Fresh frozen plasma
warfarin antidote
vitals, hematology, PT, INR, PTT
What assessments are to be performed on a patient using
anticoagulants?
PTT
normal = 20-35 seconds; on heparin therapy goal is 1.5 - 2.5
times this
2-3
INR goal for warfarin therapy?
PT
Normal range is 11-13.5 secs.
aspirin
,Common anti-platelet drug that can be purchased over the
counter, used in patients
Clopidogrel
anti-platelet used to reduce risk of stroke in patients with
history of MI, CAD, stents, bypass.
Ticlopidine
Anti-platelet drug reserved for patients allergic to aspirin;
inhibits the binding of fibrinogen to platelets during the first
stage of the clotting cascade. Used in patients that have already
had thrombotic stroke.
Dipyridamole
• Inhibits cyclic nucleotide phosphodiesterase and reuptake of
adenosine, both actions result in reduced platelet aggregation
and reactivity.
Heparin
First-line anticoagulant used for STEMI; administered with ASA,
clopidogrel, and a statin
Enoxaparin
may be used if the patient is not being referred for
percutaneous coronary intervention, during an MI
Morphine
Alleviates pain not relieved with nitrates
Produces mild vasodilation
, Atorvastatin 80 mg loading dose, then daily.
Statin that is given during MI and the dose
Beta blocker
oral ______ ________ therapy within 24 hours of cardiac event
unless contraindicated
Calcium Channel Blockers
If beta-blockers are not tolerated, consider
verapamil and dilatiazem
Examples of calcium channel blockers
162-325 MG
Aspirin loading dose for an NSTEMI
600 mg, 75mg daily
Loading dose of PLAVIX
Eptifibatide
Indicated for Acute coronary syndrome and used in
combination with heparin, aspirin, ticlid and plavix; adverse
reactions: bleeding, hypotension, thrombocytopenia, acute
toxicity: decreased muscle tone, dyspnea, loss of righting reflex;
baseline PT/aPTT, H&H, platelet count ad monitor; watch for
bleeding; quickly reversible so emergency procedures may still
be performed shortly after discontinuing infusion
Tirofiban
REVISION SUMMARY
Warfarin
Inhibits vitamin K activation of clotting factors II (prothrombin),
VII, IX, and X formed in the liver.
Protamine Sulfate
Heparin antidote
Vitamin K and Fresh frozen plasma
warfarin antidote
vitals, hematology, PT, INR, PTT
What assessments are to be performed on a patient using
anticoagulants?
PTT
normal = 20-35 seconds; on heparin therapy goal is 1.5 - 2.5
times this
2-3
INR goal for warfarin therapy?
PT
Normal range is 11-13.5 secs.
aspirin
,Common anti-platelet drug that can be purchased over the
counter, used in patients
Clopidogrel
anti-platelet used to reduce risk of stroke in patients with
history of MI, CAD, stents, bypass.
Ticlopidine
Anti-platelet drug reserved for patients allergic to aspirin;
inhibits the binding of fibrinogen to platelets during the first
stage of the clotting cascade. Used in patients that have already
had thrombotic stroke.
Dipyridamole
• Inhibits cyclic nucleotide phosphodiesterase and reuptake of
adenosine, both actions result in reduced platelet aggregation
and reactivity.
Heparin
First-line anticoagulant used for STEMI; administered with ASA,
clopidogrel, and a statin
Enoxaparin
may be used if the patient is not being referred for
percutaneous coronary intervention, during an MI
Morphine
Alleviates pain not relieved with nitrates
Produces mild vasodilation
, Atorvastatin 80 mg loading dose, then daily.
Statin that is given during MI and the dose
Beta blocker
oral ______ ________ therapy within 24 hours of cardiac event
unless contraindicated
Calcium Channel Blockers
If beta-blockers are not tolerated, consider
verapamil and dilatiazem
Examples of calcium channel blockers
162-325 MG
Aspirin loading dose for an NSTEMI
600 mg, 75mg daily
Loading dose of PLAVIX
Eptifibatide
Indicated for Acute coronary syndrome and used in
combination with heparin, aspirin, ticlid and plavix; adverse
reactions: bleeding, hypotension, thrombocytopenia, acute
toxicity: decreased muscle tone, dyspnea, loss of righting reflex;
baseline PT/aPTT, H&H, platelet count ad monitor; watch for
bleeding; quickly reversible so emergency procedures may still
be performed shortly after discontinuing infusion
Tirofiban
