PHARM EXAM 3 CCRI NURSING
Heparin - Answers- anticoagulant, prevents blood clotting that inhibit coagulation.
Most commonly prescribed to prevent DVT and acute pulmonary embolism after
orthopedic or adbdominal surgery.
PTT 1.5 - 2 (60 to 70 seconds)
aPTT 30-85 seconds (20-35 seconds)
Anti Xa 30-85 seconds being used more often.
S/E: bleeding
ANTIDOTE: protamine sulfate
Enoxaparin (Lovenox) heparine lowe molecular weight - Answers- Anticoagulant
prevents throbus formation (lower bleeding risk)
Contraindicated in stroke, peptic ulcer, blood anomalies, patients having eye, brain, or
spinal surgery.
Rivaroxaban (Xarelto) oral anticoagulant - Answers- Contraindicated in renal
impairment, prosthetic heart valves, lactation
Warafarin anticoagulant - Answers- Inhibits hepatic synthesis of vitamin K, affecting the
clotting factors II, VII, IX and X. Used mainly to prevent thrombophlebitis, pulmonary
Embolism, and Embolism formation caused by AFib, which can lead to stroke CVA
Therapeutic range pt 1.25- 2.5 times control value (11-15 seconds)
INR 2-3 (normal 1.3-2)
ANTIDOTE: Vitamin K must be done in 24-48 h
For patients : weekly labs, diet: nondark leafy greens (k+) no wine
Oral contraceptives, ASA make warafarin mornpotent so shouldnt be used.
If on warafarin and fall is caused ct of the head must be done.
S/E: bleeding monitor for and s/s of bleeding dark tarry stools low bp, high HR monitor
cbc
Warafarin antidote - Answers- Vitamin K
Alteplase (tPA activase) thrombolytic - Answers- For DVT, MI, PE, Stroke, ocluded
central venous acces devices. (Dissolves clots)
Directly converts plasminogen to plasmin which then degrades clot bound fibrin
Works whithin 4 hours
Should be administered whithin 3 hours of thrombotic stroke
Monitor: vs, lab values, s/s hemorhage, allergic reactions, AVOID ASPIRIN, ekg, Avoid
needle sticks. (Use smallest gauge 25)
Aspirin - Answers- ASA (acetylsalicylic acid)
Supressing platelet agregation, long term low dose use 81 mg, inhibits cyclooxygenase,
an enzyme needed by platelets to synthesize thromboxane a2 ( Txa2)
, Clopidogrel (Plavix) Antiplatelet - Answers- Used after MI or stroke to prevent another
one from happening, used with asparin,
Inhibits platelet agregation. Prevents adp from binding with platelet receptor.
Contraindications: anticranial hemorhage, PUD, GI Bleeding
Increased risk of bleeding when taking with NSAIDS, anticoagulants, ginger, garlic,
ginko, green tea
Prolongs bleeding time,
Lorazepam (Ativan) benzodiazepines DO NOT CRUSH! - Answers- for Anxiety,
interacts with neurotransmiter GABA to reduce neuron excitability.
Contrainidcated w/ angle clousure glaucoma, sleep apnea, cns depression,
hypotension.
S/E: apnea, cardiac arrest, rah, blurred vission, physical dependence
Antidote: flumazenil (not for pt with seizure disorder)
Assess vs, renal function
Pt teaching: dont double dose, dont stop abruptly, caution w/o otc meds. Take before
bedtime, not with alcohol. Dont drive.
Diphenhydramine (Benadryl) - Answers- Allergy cold and cough remedies.
Antogonizes the effects of histamine at H1 receptor sites, does not bind to or inactivate
histamine.
Contraindicated in acute attacks of asthma and lactation
S/E photosensitivity, dry mouth, drowsiness
Assess cough, urticuria, rhinorea, n+v rash. And geri causes sedation and confusion
Teach patient use sunscreen, not to take otc meds, avoid nicotine and caffiene.
Zolpiden (Ambien) sedative hypnotic cs: IV non benzodiazepines - Answers- Last 6-8
hrs. Half life : 2-4.5 hrs
Cns depression by binding to GABA receptors
neurotransmitter inhibition. Treats short term insomia.
S/E: parasomnias such as nightmares or sleep walking
Comtraindicated in sleep apnea
Avoid driving, alcohol, sleep driving
Carbamazepine (Tegretol) DO NOT CRUSH - Answers- anticonvulsant/mood
stabilizer- prevents seizures, relief of pain in trigemina, neuralgia, and decreased mania
Decreases synaptic transmission in the CNS by affecting sodium channels in neurons
Therapeutic level 5-12 mcg/ml
Dont take with grapefruit!! (Toxic)
Contraindications: bone marrow supression, MAO inhibitors, lactation
S/E: dress, helatoxicity, pancreatitis, S/I, sjs.
Monitor for mental status, cbc, seizures, liver function.
Teach pt of s/s of bleeding, behavioral changes, s/i
Gabapentin (Neurontin) anticonvulsant - Answers- Used for: seizures, neuralgia,
restless leg syndrome, UU: migraines, bd, anxiety, dm neuropathy
Heparin - Answers- anticoagulant, prevents blood clotting that inhibit coagulation.
Most commonly prescribed to prevent DVT and acute pulmonary embolism after
orthopedic or adbdominal surgery.
PTT 1.5 - 2 (60 to 70 seconds)
aPTT 30-85 seconds (20-35 seconds)
Anti Xa 30-85 seconds being used more often.
S/E: bleeding
ANTIDOTE: protamine sulfate
Enoxaparin (Lovenox) heparine lowe molecular weight - Answers- Anticoagulant
prevents throbus formation (lower bleeding risk)
Contraindicated in stroke, peptic ulcer, blood anomalies, patients having eye, brain, or
spinal surgery.
Rivaroxaban (Xarelto) oral anticoagulant - Answers- Contraindicated in renal
impairment, prosthetic heart valves, lactation
Warafarin anticoagulant - Answers- Inhibits hepatic synthesis of vitamin K, affecting the
clotting factors II, VII, IX and X. Used mainly to prevent thrombophlebitis, pulmonary
Embolism, and Embolism formation caused by AFib, which can lead to stroke CVA
Therapeutic range pt 1.25- 2.5 times control value (11-15 seconds)
INR 2-3 (normal 1.3-2)
ANTIDOTE: Vitamin K must be done in 24-48 h
For patients : weekly labs, diet: nondark leafy greens (k+) no wine
Oral contraceptives, ASA make warafarin mornpotent so shouldnt be used.
If on warafarin and fall is caused ct of the head must be done.
S/E: bleeding monitor for and s/s of bleeding dark tarry stools low bp, high HR monitor
cbc
Warafarin antidote - Answers- Vitamin K
Alteplase (tPA activase) thrombolytic - Answers- For DVT, MI, PE, Stroke, ocluded
central venous acces devices. (Dissolves clots)
Directly converts plasminogen to plasmin which then degrades clot bound fibrin
Works whithin 4 hours
Should be administered whithin 3 hours of thrombotic stroke
Monitor: vs, lab values, s/s hemorhage, allergic reactions, AVOID ASPIRIN, ekg, Avoid
needle sticks. (Use smallest gauge 25)
Aspirin - Answers- ASA (acetylsalicylic acid)
Supressing platelet agregation, long term low dose use 81 mg, inhibits cyclooxygenase,
an enzyme needed by platelets to synthesize thromboxane a2 ( Txa2)
, Clopidogrel (Plavix) Antiplatelet - Answers- Used after MI or stroke to prevent another
one from happening, used with asparin,
Inhibits platelet agregation. Prevents adp from binding with platelet receptor.
Contraindications: anticranial hemorhage, PUD, GI Bleeding
Increased risk of bleeding when taking with NSAIDS, anticoagulants, ginger, garlic,
ginko, green tea
Prolongs bleeding time,
Lorazepam (Ativan) benzodiazepines DO NOT CRUSH! - Answers- for Anxiety,
interacts with neurotransmiter GABA to reduce neuron excitability.
Contrainidcated w/ angle clousure glaucoma, sleep apnea, cns depression,
hypotension.
S/E: apnea, cardiac arrest, rah, blurred vission, physical dependence
Antidote: flumazenil (not for pt with seizure disorder)
Assess vs, renal function
Pt teaching: dont double dose, dont stop abruptly, caution w/o otc meds. Take before
bedtime, not with alcohol. Dont drive.
Diphenhydramine (Benadryl) - Answers- Allergy cold and cough remedies.
Antogonizes the effects of histamine at H1 receptor sites, does not bind to or inactivate
histamine.
Contraindicated in acute attacks of asthma and lactation
S/E photosensitivity, dry mouth, drowsiness
Assess cough, urticuria, rhinorea, n+v rash. And geri causes sedation and confusion
Teach patient use sunscreen, not to take otc meds, avoid nicotine and caffiene.
Zolpiden (Ambien) sedative hypnotic cs: IV non benzodiazepines - Answers- Last 6-8
hrs. Half life : 2-4.5 hrs
Cns depression by binding to GABA receptors
neurotransmitter inhibition. Treats short term insomia.
S/E: parasomnias such as nightmares or sleep walking
Comtraindicated in sleep apnea
Avoid driving, alcohol, sleep driving
Carbamazepine (Tegretol) DO NOT CRUSH - Answers- anticonvulsant/mood
stabilizer- prevents seizures, relief of pain in trigemina, neuralgia, and decreased mania
Decreases synaptic transmission in the CNS by affecting sodium channels in neurons
Therapeutic level 5-12 mcg/ml
Dont take with grapefruit!! (Toxic)
Contraindications: bone marrow supression, MAO inhibitors, lactation
S/E: dress, helatoxicity, pancreatitis, S/I, sjs.
Monitor for mental status, cbc, seizures, liver function.
Teach pt of s/s of bleeding, behavioral changes, s/i
Gabapentin (Neurontin) anticonvulsant - Answers- Used for: seizures, neuralgia,
restless leg syndrome, UU: migraines, bd, anxiety, dm neuropathy
