Chapter 19 Agents Affecting Blood Clotting Blood Clotting

Chapter 19 Agents Affecting Blood Clotting

Blood Clotting Thromboemboli l £ Cause many deaths per year Anticoagulants l £ Prevent the formation of coagulants 2 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Anticoagulant Agents Inhibit the formation of clots l £ Heparin u £ Found in mast cells Action u Inhibit the clotting process 3 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Heparin action l £ £ 4 Indirectly interferes with the conversion of prothrombin to thrombin The deficiency of thrombin prevents the conversion of fibrinogen to fibrin (continues) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

(continued) Heparin Destroyed if given orally Administered via IV infusion l l £ No intramuscular injections Administered subcutaneously l £ £ Longer acting form No intramuscular injections 5 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Heparin: Side Effects Hemorrhage Allergy Antidote l l l £ Protamine sulfate Caution l £ Do not administer to clients with coagulation disorders 6 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Low Molecular Weight Anticoagulant Related to heparin l £ Minor risk for bleeding Does not affect the action of thrombin in the clotting cascade l 7 (continues) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

(continued) Low Molecular Weight Anticoagulant Example: enoxaparim (Lovenox) l 8 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Oral Anticoagulants Warfarin (Coumadin) l £ Inhibits blood clotting by interfering with the synthesis of vitamin K-dependent clotting factors Close client monitoring l £ £ Dosage is individualized International normalized ratio 9 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Antiplatelet Agents Action: inhibit the aggregation of platelets l £ Treat clients who have had cerebrovascular accidents or myocardial infarctions 10 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Antiplatelets Examples l £ £ £ Aspirin Abciximab (Reo. Pro) Clopidogrel bisulfate (Plavix) 11 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Thrombolytic Agents l Action £ l Example £ l Convert plasminogen to enzyme fibrinolysin; fibrinolysin dissolves clots Streptokinase (IV) Caution £ Hemorrhage 12 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.