blood flash cards
TRANSCRIPT
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Anticoagulants
(Parenteral)
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: Heparin — Others: enoxaparin, tinzaparin
• Intrinsic factors and thrombin conversion are inhibited by heparin
Therapeutic Uses: • Evolving stroke, E, !I, "#$ • "%ring pregna
• &d'%nct d%ring s%rgery, dialysis, abdominal s%rgery, or 'oint replacem• "isseminated intravasc%lar coag%lation
Adverse Effects: • Hypersensitivity reaction (chills, fever, %rticaria)
• Hemorrhage * heparin +" (treat protamine sulfate)
• Heparin-ind%ced thrombocytopenia (stop if .$ / 011,1112cc)
Contraindications/Precautions: • 3I: .$ or %ncontrollable bleeding
• 3I: 4%rgery of eye, brain, spinal cord5 regional anesthesia5 l%mbar p%nct
Interactions: • &nti-platelet agent additive risk of bleeding
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Education: • !onitor a$$ levels 67-8h and then 6" (81-91 sec)
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Treatment of Hearin !"
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: rotamin
• inds ;ith heparin and forms a non-coag%lating complex
Therapeutic Uses: • &ntidote to severe heparin overdose
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Anticoagulant(!ral)
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: ;arfarin (3o
• &ntagonizes vitamin > 2 prevents synthesis of 7 intrinsic factors ? proth
Therapeutic Uses: • revention of veno%s thrombosis
• revention of thrombi in &-fib and ;ith prosthetic heart valves
Adverse Effects: • Hemorrhage ($x ;ith vitamin >)
•
Contraindications/Precautions: • Pregnancy (X)
• 3I: 4%rgery of eye, brain, spinal cord5 regional anesthesia5 l%mbar p%nct
•3I: .$ co%nts, %ncontrolled bleeding, vit@ > A, liver problems, alcoh
Interactions: • Heparin, aspirin, glucocorticoids bleeding
• Acetaminophen, sulfonamides, parenteral cephalosporins, ASA B;a
• Phenobarbital, carbamazepine, phenytoin, OC, vitamin K ;arfarin
Education: • $ therape%tic level D 09-7 sec (normal D 00-0@= sec)
•
+nset takes 9-0 hrs, f%ll effect takes -= days
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Treatment of #arfarin !"
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: #itamin > (hyton
• romote synthesis of intrinsic factors and prothrombin
Therapeutic Uses: • #itamin > deficiency
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Antilatelets
N203 ATI (Unit 7
Hematologic Sy
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Expected
Action:
Proto: &spirin — Others: ticlopidine ($iclid), clopidogrel
dipyridamole (ersantine), abciximab (<
• revent platelet cl%mping by inhibiting arterial clotting enzymes and fac
Therapeutic Uses: • rimary prevention of ac%te !I • revention o
• revention of reinfarction
• &c%te coronary syndromes (abciimab and tirofiban !Aggrastat")
Adverse
Effects:
• FI effects (conc%rrent I 2 enteric-coated 2 take food)
• Hemorrhagic stroke
Contraindications/Precautions: • regnancy (")
Interactions: •
• !edications that enhance bleeding additive risk for bleeding
Education: •
• &4& (90 mg) for prevention 2 &4& (= mg) d%ring initial ac%te !I epi
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T$rom%olytic &e'ications
N203 ATI (Unit 7
Hematologic Sy
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Iron Prearations
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: Gerro%s s%lfate — Others: Iron
• Increase iron level for
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itamin 12(*yanoco%alamin)
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: #itamin 12 (cyanocob
• Lecessary to convert folate (re%ired for "L& prod%ction) from inactive
Therapeutic Uses: •
$reatment of 12 deficiency• !egaloblastic (macrocytic) anemia related to 12 deficiency
Adverse Effects: •
• Hypokalemia *
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+olic Aci'
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: Go
• Golic acid is essential in "L& prod%ction ? erythropoiesis (
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Hematooietic ,rot$ +actors
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: Epoetin alfa (Epogen, rocrit) — Others: darbepo
• &ct on bone marro; to
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,ranulocyte *olonyStimulating +actor
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: filgrastim (Le%pogen) — Others: pegfilgrastim (L
• !edications stim%late bone marro; to prod%ction of ne%trophils@
Therapeutic Uses: •
infection risk ;ith ne%tropenia (e@g@ cancer)Adverse Effects: • one pain
• .e%kocytosis: dose 2 interr%pt treatment if M3 N =1,1112cc, &L3 N
1,1112cc, or platelets N =11,1112cc@
Contraindications/Precautions: • 3I: 4ensitive to () coli proteins
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Interactions: •
•
Education: • *ilgrastim sho%ld not be agitated nor mixed
• !onitor 33 x per ;eek
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,ranulocyte &acro$age*olony Stimulating +actor
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: Proto: 4argramostim (.
• prod%ction of M3s in bone marro;
Therapeutic Uses: •
• Gacilitates recovery of bone marro; after marro; transplant@
Adverse Effects: • "iarrhea, ;eakness, rash, malaise, and bone pain (call
• .e%kocytosis, thrombocytosis: O if M3N=1,111, &L3N1,111, .$N=
Contraindications/Precautions: • 3I: &llergic to yeast prod%cts
• 3a%tion disease, hypoxia, peripheral edema, ple%ral2pericardial eff%s
Interactions: •
•
Education: • Sargramostim sho%ld not be agitated nor mixed ;ith other
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Expected Action: Proto: oprelvekin (Interle%kin 00, L
• Increases prod%ction of platelets@
Therapeutic Uses: • thrombocytopenia myelos%ppressive chemotheAdverse Effects: • Gl%id retention (peripheral edema, dyspnea on exertio
• "ysrhythmias • 3on'%nctival in'ection, transient bl%rring, and papill
Contraindications/Precautions: •
•
Interactions: •
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Education: • $reat for 0 days or %ntil .$ N =1,111
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#$ole loo'
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: • Increases circ%lating blood vol%me
Therapeutic Uses: • &c%te blood loss, extensive b%rns, dehydration, shoc
Adverse Effects: • 4epsis (c%lt%re, antibiotics, I# fl%ids, vasopressors, st
• &c%te hemolytic rxn (fever, tachycardia, hypotension): #4 6=m for 0=m
• Gebrile nonhemolytic rxn (most common) (fever, headache): #4 6=m fo
• &naphylaxis: #4 6=m for 0=m P I! or I# epinephrine
• !ild allergy: If respiration %ncompromised, antihistamines and restart
• 3irc%latory overload: lace %pright 2 + and di%retics 2 slo;er rate
Education: •
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Pac.e' /*s
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: • U of
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Platelet *oncentrate
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: • platelet co%nt
Therapeutic Uses: • $hrombocytopenia (/ 1,1112cc)
• &ctive bleeding (platelets / 91,1112cc)
Adverse Effects: • 4epsis (c%lt%re, antibiotics, I# fl%ids, vasopressors, st
• Gebrile nonhemolytic rxn (most common) (fever, headache): #4 6=m fo
• !ild allergy: If respiration %ncompromised, antihistamines and restart
Education: •
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+res$ +roen Plasma
N203 ATI (Unit 7
Hematologic Sy
E t d A ti •
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Expected Action: •
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P$erese' ,ranulocytes
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: •
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Al%umin
N203 ATI (Unit 7
Hematologic Sy
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Expected Action: • Expands circ%lating blood vol%me by oncotic press%re
Therapeutic Uses: • Hypovolemia • %rns • &d%lt respiratory distre
• Hypoalb%minemia • 3ardiop%lmonary bypass s%rger
• Hemolytic disease of the ne;born
Adverse Effects: •
•