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40 Cards in this Set
- Front
- Back
the process of forming clots in the walls of damaged blood vessels to prevent blood loss while maintaining blood in a fluid state within a vessel
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hemostasis
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inappropriate clot formation
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thrombosis
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a blood clot
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thrombus
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4 ways hemostasis happens
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1. local vasoconstriction
2. formation of a platelet plug 3. blood clot due to coagulation 4. fibrinolysis |
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true or false:
a group of platelets aggregate to form a clot that prevents blood loss from the vessel |
true
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prothrombin -> thrombin = creates cross linked fibrin &...
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plasminogen -> plasmin = breaks down fibrin
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a dislodged thrombus or bits of thrombus
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emboli
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emboli can lead to _____ or ______
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1. ischemia
2. infarction |
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reduction in blood supply or flow
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ischemia
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loss of blood flow leading to localized tissue death
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infarction
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There is an increased incidence of thrombosis with...
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1. endothelial injury
2. abnormal blood flow - stasis 3. hypercoaguability |
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What are the three types of pharmacological interventions to treat thrombosis?
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1. antiplatelets
2. anticoagulants 3. thrombolytics |
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____________ - prevent platelet activation and thus prevent clot formation
(work at the platelet level) |
antiplatelets
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___________ - inhibit clotting cascade to ultimately prevent fibrin clot formation
(prevent the fibrin from "meshing") |
anticoagulants
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__________ - dissove an existing clot by digesting fibrin
(the only one that can dissolve an existing clot) |
thrombolytics
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Indications for anti-platlet drugs...
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1.prevent or treat cardiovascular disease
2.maintain patent arteries, vascular grafts, shunts 3.adjuncts to thrombolytic therapy for MI patients 4.cerebrovascular disease/stroke 5.peripheral vascular disease |
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What are the 4 groups of antiplatlet drugs?
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1. aspirin
2. dipyridamole 3. clopidogrel/ticlopidine 4. abciximab/eptifibatide |
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What is the antiplatlet drug of choice?
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aspirin
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Important things about aspirin...
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-inhibits thromboxane (which prevents platelets from sticking together
- low dose = prevents action of platelets -high dose = prevents action of platelets and prevents them from coming together(aggregation) |
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Important things about dipyridamole...
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-blocks platelet aggregation and blocks thromboxane production
-short duration of action |
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Important things about clopidogrel/ticlopidine...
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- decreases ADP induced platlet aggregation
-long onset of action (does not work immediately) -clopidogrel is less toxic than ticlopidine |
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Side effects of Clopidogrel/ticlopidine...
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-prolonged bleeding
-neutropenia (loss of neutrophils) |
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Side effects of aspirin...
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-increased incidence of hemorrhagic stroke
-GI bleeding |
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Important things about Abciximab/Eptifibatide...
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-onset of action 30 mins (peak 2 hrs)
-works differently than the others (out instead of in) -never given alone -can't stick to the outside of platelet |
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Side effects for Abciximab/Eptifibatide...
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-hemorrhage
-concurrent use of warfarin is contraindicated |
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Two types of anticoagulants &
example of each |
1. oral - warfarin
2. parental - heparin |
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Important things about anticoagulants...
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-prevent crosslinking of fibrin & becoming insoluable
-indicated for pts with or at risk of having thromboembolic disorders (PE, MI, DVT, stroke, & atrial fib) |
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Antagonist for heparin
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protamine sulfate
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side effects for heparin
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-hemorrhage
-thrombocytopenia (loss of platelets) |
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Important things about warfarin...
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-most widely used oral anticoagulant
-phytonadione (vit k1) is used to reverse bleeding associated with warfarin |
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Important things about thrombolytics...
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-only effective if used rapidly after onset of clot (less than a few hrs)
-breaks an existing clot apart |
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two types of thrombolytics (with examples)
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1. combine with plasminogen to make an active complex to convert to plasmin (streptokinase)
2. actually converts plasminogen to plasmin (tPA, reteplase, tenecteplase) |
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most dangerous side effect of thrombolytics
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hemorrhage, especially intracranial hemorrhage
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streptokinase
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doesn't just work at the clot
(works systemically) (others work only at the clot) |
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Reteplase and tenecteplase
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are more convienient
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decrease in the number of red blood cells
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anemia
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how is anemia measured
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by hematocrit level
40-52% M 35-47% F |
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plasma volume increases when
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pt is lying down and when pt quits smoking
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anemia can produce ____, ____, and ____ deficiencies
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vit b12, folate, iron
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pharmacologically treat vitamin deficiency anemia by
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replacement therapy
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