Page 1 of 13
Drugs for Exam 3
Chapter 31: Drugs for Coagula on Disorders
Indirect Thrombin Inhibitors
1. heparin
• I: Prophylaxis for thromboembolic events from immobility or vascular procedures; surgery; higher
doses are used to treat DVT & pulmonary emboli; MI
• MOA: Inhibits thrombin preven ng brinogen from conver ng to brin
• SE: unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelet levels; Check IV site for in ltra on
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: - Protamine Sulfate
• (3) G’s can poten ate e ects: Garlic, Ginger, Gingko
• Some pa ents can become allergic to Heparin (Heparin induced Thrombocytopenia - HIT) for those
they will use argatroban (Acova)
2. fondaparinux (Arixtra)
• Used for orthopedic surgeries
Vitamin K Antagonist
3. warfarin (Coumadin)
• I: Prophylaxis for thromboembolic events related to atrial brilla on
• MOA: Inhibits the ac on of vitamin K, preven ng the synthesis of clo ng factors
• SE: unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelets; Check INR
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: Vitamin K (aquami n)
• (3) G’s can poten ate e ects: Garlic, Ginger, Gingko
• Maintain your food levels high in vitamin K: especially green leafy
• Used for orthopedic surgeries
Low-Molecular Weight Heparin
4. enoxaparin (Lovenox)
5. dalteparin (Fragmin)
• I: Prophylaxis for DVT
• MOA: Inhibits factor x; part of the clo ng cascade
• SE: unusal bruising
• AE: GI or cerebral bleeding
• NR: Check platelets
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: Protamine Sulfate
• Lovenox has nitrogen gas plug bubble; helps prevent from leaking out; good injec on = no bruising
Direct Thrombin Inhibitors
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, Page 2 of 13
• I: For pa ents with Heparin induced thrombocytopenia (HIT); used in place of Heparin for
prophylaxis of thromboembolic events
• MOA: binds to thrombin preven ng clot forma on (it’s an an coagulant)
• SE: unusal bruising
• AE: GI or cerebral bleeding
• NR: Check Platelets; Check IV site for in ltra on
• Contraindica ons: Recent trauma, ac ve bleeding; severe HTN
• Vit C may give false nega ve reading; can inhibit e ects of medica on
• Vit E can increase INR (bleeding me) - Sun ower seeds, almonds, spinach, avocados
Factor Xa Inhibitors
7. apixaban (Eliquis)
8. rivaroxaban (Xarelto)
An platelet Drugs & (Non-Steroidal An -In ammatory)
9. aspirin (ASA, acetylsalicylic acid)
• I: prevents clot forma on in arteries; prophylaxis for stroke or MI
• MOA: inhibits platelet aggrega on by inhibi ng the COX-1 & COX-2 enzyme; inhibits prostaglandin
synthesis; Binds to cycloxygenase on platelet surfaces preven ng platelet aggrega on for up to 10
days
• SE: unusual bruising, bleeding gums, stomach pain
• AE: GI or cerebral bleeding; nnitus, metabolic acidosis, Reyes Syndrome (kids)
• NR: Check platelet levels
• Administra on Alerts: ASA’s ability to inhibit platelet aggrega on is irreversible and e ects can last
up to 10 days; should be d/c (1) week prior to any surgical procedure; should not be used w/ pa ents
on an coagulants such as Heparin or Coumadin
• Contraindica ons: Pa ents on Heparin or Coumadin
• Treatment of Overdose: Ac vated charcoal; gastric lavage; Assess for and promptly report adverse
e ects of GI bleeding (dark or ????
• Drug -to-Drug: ETOH, steroids, other NSAID’s poten ate e ects of ASA & increase risk of gastric
ulcers. (3) G’s: Ginger, Garlic, Gingko
• Pregnancy Cat: D
ADP Receptor Blockers
10. Prototype: clopidogrel (Plavix)
11. prasugrel (E ent)
12. cagrelor (Brilinta)
13. clopidine (Ticlid)
• I: reduces rate of infarc on with an MI; reduces occurrence of MI or stroke in pa ents with
atherosclerosis
• MOA: Inhibits platelet aggrega on by blocking (ADP) receptor sites on thrombocytes
• SE: Unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelet levels
Glycoprotein IIB/IIIA Receptor Antagonists
14. abciximab (ReoPro)
15. ep ba de (Integrlin)
16. ro ban (Aggrastat)
tifftifi
tifi ti titi tiffiti
tititi ti titi tititi tifiti fltifl ti ffti ff titi ti ti ti ff ti
Drugs for Exam 3
Chapter 31: Drugs for Coagula on Disorders
Indirect Thrombin Inhibitors
1. heparin
• I: Prophylaxis for thromboembolic events from immobility or vascular procedures; surgery; higher
doses are used to treat DVT & pulmonary emboli; MI
• MOA: Inhibits thrombin preven ng brinogen from conver ng to brin
• SE: unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelet levels; Check IV site for in ltra on
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: - Protamine Sulfate
• (3) G’s can poten ate e ects: Garlic, Ginger, Gingko
• Some pa ents can become allergic to Heparin (Heparin induced Thrombocytopenia - HIT) for those
they will use argatroban (Acova)
2. fondaparinux (Arixtra)
• Used for orthopedic surgeries
Vitamin K Antagonist
3. warfarin (Coumadin)
• I: Prophylaxis for thromboembolic events related to atrial brilla on
• MOA: Inhibits the ac on of vitamin K, preven ng the synthesis of clo ng factors
• SE: unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelets; Check INR
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: Vitamin K (aquami n)
• (3) G’s can poten ate e ects: Garlic, Ginger, Gingko
• Maintain your food levels high in vitamin K: especially green leafy
• Used for orthopedic surgeries
Low-Molecular Weight Heparin
4. enoxaparin (Lovenox)
5. dalteparin (Fragmin)
• I: Prophylaxis for DVT
• MOA: Inhibits factor x; part of the clo ng cascade
• SE: unusal bruising
• AE: GI or cerebral bleeding
• NR: Check platelets
• Contraindica ons: Recent trauma, ac ve bleeding, severe HTN
• Admin Alerts: Treatment of Overdose: Protamine Sulfate
• Lovenox has nitrogen gas plug bubble; helps prevent from leaking out; good injec on = no bruising
Direct Thrombin Inhibitors
ti ti ti ti ff ti fi tti
ti fiti
ti ti fiti
fiti tifi tti ti
, Page 2 of 13
• I: For pa ents with Heparin induced thrombocytopenia (HIT); used in place of Heparin for
prophylaxis of thromboembolic events
• MOA: binds to thrombin preven ng clot forma on (it’s an an coagulant)
• SE: unusal bruising
• AE: GI or cerebral bleeding
• NR: Check Platelets; Check IV site for in ltra on
• Contraindica ons: Recent trauma, ac ve bleeding; severe HTN
• Vit C may give false nega ve reading; can inhibit e ects of medica on
• Vit E can increase INR (bleeding me) - Sun ower seeds, almonds, spinach, avocados
Factor Xa Inhibitors
7. apixaban (Eliquis)
8. rivaroxaban (Xarelto)
An platelet Drugs & (Non-Steroidal An -In ammatory)
9. aspirin (ASA, acetylsalicylic acid)
• I: prevents clot forma on in arteries; prophylaxis for stroke or MI
• MOA: inhibits platelet aggrega on by inhibi ng the COX-1 & COX-2 enzyme; inhibits prostaglandin
synthesis; Binds to cycloxygenase on platelet surfaces preven ng platelet aggrega on for up to 10
days
• SE: unusual bruising, bleeding gums, stomach pain
• AE: GI or cerebral bleeding; nnitus, metabolic acidosis, Reyes Syndrome (kids)
• NR: Check platelet levels
• Administra on Alerts: ASA’s ability to inhibit platelet aggrega on is irreversible and e ects can last
up to 10 days; should be d/c (1) week prior to any surgical procedure; should not be used w/ pa ents
on an coagulants such as Heparin or Coumadin
• Contraindica ons: Pa ents on Heparin or Coumadin
• Treatment of Overdose: Ac vated charcoal; gastric lavage; Assess for and promptly report adverse
e ects of GI bleeding (dark or ????
• Drug -to-Drug: ETOH, steroids, other NSAID’s poten ate e ects of ASA & increase risk of gastric
ulcers. (3) G’s: Ginger, Garlic, Gingko
• Pregnancy Cat: D
ADP Receptor Blockers
10. Prototype: clopidogrel (Plavix)
11. prasugrel (E ent)
12. cagrelor (Brilinta)
13. clopidine (Ticlid)
• I: reduces rate of infarc on with an MI; reduces occurrence of MI or stroke in pa ents with
atherosclerosis
• MOA: Inhibits platelet aggrega on by blocking (ADP) receptor sites on thrombocytes
• SE: Unusual bruising
• AE: GI or cerebral bleeding
• NR: Check platelet levels
Glycoprotein IIB/IIIA Receptor Antagonists
14. abciximab (ReoPro)
15. ep ba de (Integrlin)
16. ro ban (Aggrastat)
tifftifi
tifi ti titi tiffiti
tititi ti titi tititi tifiti fltifl ti ffti ff titi ti ti ti ff ti
