Chapter 48-49 Cardiovascular Drugs 3: Drugs Affecting Blood coagulation and Anemia

KEY
Class/Medications Action Indication Adverse Effects Misc.
Antiplatelet agents Inhibit platelet prevent CV Bleeding -  Cautions:
adhesion and occlusion, bruising, bleeding Known bleeding
Aspirin (generic) aggregation prevention of while brushing disorders
reinfarction and teeth Recent surgery
used in MI Nausea and GI Closed head injuries
distress (risk of bleeding from
Skin rash injured vessels)
Pregnancy (benefits
to mother outweigh
risk to fetus)

Clopidogrel (Plavix) Used to treat CV Bleeding. Stop 7 Some people are

Ticagrelor (Brilinta) disease that days before Clopidogrel resistant.
produces procedure that can If used with
occluded vessels cause problems. omeprazole may
(graft decrease antiplatelet
maintenance); effects
stents

Anticoagulants Interfere with Heparin-prevent Bleeding. Heparin injected

Heparin clotting cascade and and treat Heparin does not subcut. or IV.
Different strengths: thrombin formation. venous enter breast milk. Immediate onset.
Heparin lock- 100 thrombosis, PE, HIT. Heparin- Monitor APTT 1.5-
Heparin injectable a. fib, prevents induced- 2.5 times control.
1000-5000 clotting in lines- thrombocytopenia Antidote: Protamine
dialysis. Sulfate
See p. 839 focus on Treatment MI
Safe Med. admin. and CVA

Warfarin (Coumadin) Warfarin decreases Warfarin: atrial Bleeding. Warfarin oral, onset
Vitamin K clotting fib Contraindicated in 3 days. Lasts for 3-5
See p. 838 focus on factors in liver. pregnancy. Many days.
Safe Med. admin. Depletes clotting drug-drug Eat same amt. green
factors and interactions. Many leafy vegetables. If
lengthens clotting problems in moving from heparin
times hospitals related to to warfarin, keep on
drug. heparin while
Many drug-drug starting. Monitor PT
interactions p.839 1.3-1.5 or INR of 2-
Food and INR 3.5 Antidote: vitamin
K
 Chapter 48-49 Cardiovascular Drugs 3: Drugs Affecting Blood coagulation and Anemia
KEY
Class/Medications Action Indication Adverse Effects Misc.

** Low molecular Block factors Xa and Prevent DVTs Bleeding. Fewer Give in “love
Weight Heparin IIa. Size molecules, adverse effects than handles” or
Enoxaparin (Lovenox) don’t affect Heparin. Don’t use abdomen; Do not
thrombin, clotting or together. eject air bolus before
PT. Hypersensitivity to giving medication
protamine

** Anticoagulant
Adjunctive Therapy Protamine Sulfate- Inactivates Given IV- quick onset
Protamine Sulfate strong base forms heparin-
complex with
Heparin

Vitamin K Vitamin K promotes Reverses Delay in action for

liver synthesis of warfarin Vit. K 24 hours. Give
clotting factors. subcut or IM

Class/Medication Action Indication Adverse Effects Misc.

Erythropoiesis Glycoprotein Treat anemia in Headache, Peaks 5-24 hours,
Stimulating Agents stimulates formation renal failure, arthralgias, GI lasts 24 hours. Given
Epoetin Alfa RBC in bone marrow chronic kidney effects, CV, HPT IV or subcut
Epogen disease, HIV,
chemotherapy
Agents Used in Iron Elevate serum iron Iron deficiency GI irritation Given orally. Can give
Deficient Anemia anemia Dark stools, iron in other ways IM
Ferrous Sulfate constipation z track- IV
Increase fluids

Table 48.2 Review of Clotting Studies p. 835