Anti-Platelet Aggregate

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Outline

Overview

  1. Overview
    1. Purpose
      1. Prevent the formation of thrombi, aka thrombo-prevention
    2. Mechanism of Action
      1. Most common pathway: Cyclooxygenase inhibition
        1. Basically, operates within platelets and BV walls
        2. Prevents formation of TXA2
          1.    Causes BV to constrict & platelets to aggregate
      2. There are various pathways
        1.     Clotting factors VII, IX, X
  2. Indications
    1. Stroke risk reduction
    2. Stroke prophylaxis
    3. Acute unstable MI
    4. Thromboembolic complications
    5. Thromboembolic disorders
    6. Post-MI thrombo-prevention
    7. PCI (angioplasty)
  3. Types
    1. Glycoprotein IIb/IIIa Inhibitors
      1. Abcimab
      2. Eptifibitide
      3. Tirofiban
    2. Aggregation Inhibitors / Vasodilators
      1. Treprostinil
    3. Aggregation Inhibitors
      1. Cilostazol
      2. Clopidogrel
    4. Miscellaneous
      1. Anagrelide
      2. Dipyridamole
  4. Contraindications
    1. Drug allergy
    2. Thrombocytopenia
    3. Active bleeding
    4. Leukemia
    5. Traumatic injury
    6. GI ulcer
    7. Vitamin K deficiency
    8. Recent stroke
  5. Interactions

    A.    Heparin

    B.    Oral antidiabetic drugs

    C.     Dipyridamole

    D.    Steroids

  6. Side Effects

    A.    Aspirin

    1.     CNS

    a.     Drowsiness

    b.     Dizziness

    c.     Confusion

    d.     Flushing

    2.     GI

    a.     N / V / D

    b.     GI Bleeding

    c.     Heartburn

    3.     Hematologic

    a.     Thrombocytopenia

    b.     Leukopenia

    c.     Anemia

    d.     Bleeding

    B.    Clopidogrel

    1.     Cardiovascular

    a.     Chest pain, HTN, edema

    2.     CNS

    a.     Flulike symptoms

    b.     Headache

    c.     Dizziness

    d.     Fatigue

    3.     GI

    a.     Abdominal pain

    b.     Dyspepsia

    c.     Diarrhea

    d.     Nausea

    4.     Miscellaneous

    a.     Epistaxis

    b.     Rash

    C.     GP IIb / IIIa Inhibitors

    1.     Bleedings

    2.     Bradycardia

    3.     Dizziness

    4.     Edema

    5.     Leg pain

    6.     Pelvic pain

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Transcript

Welcome back and today we are going to discuss anti-platelet aggregrates.

Alright, let’s do a quick review. The purpose of anti-platelet aggregates is thrombus prevention. Now don’t get them confused with dissolve current clots. These simply prevent FUTURE thrombus formation.

The mechanism of actions is the inhibition of Cyclooxygenase. Basically it works within the platelet and BV walls to dilate and prevent platelet grouping. It also prevents the formation of TXA2, which has prothrombotic properties.

Alright, let’s do a quick review. The purpose of anti-platelet aggregates is thrombus prevention. Now don’t get them confused with dissolve current clots. These simply prevent FUTURE thrombus formation. The mechanisms of actions are the inhibition of Cyclooxygenase. Basically it works within the platelet and BV walls to dilate and prevent platelet grouping.

Types of anti-platelet aggregates include glycoprotein inhibitors, aggregation inhibitors, aggregation inhibitors with vasodilation properties and miscellaneous. An easy way to remember this is GAAM.

Anti-platlet contraindications are plentiful and include drug allergies, thrombocytopenia, active bleeding, leukemia, traumatic injury, GI ulcer, vitamin K deficiency, and a recent stroke. All of which are side effects of the very drug class. So, we wouldn’t want a patient who is at risk of bleeding receiving a drug that will exacerbate that condition. We want therapeutic responses in the right settings.

Heparin + glycoproteins = increased bleeding potential, oral antidiabetic drugs + aspirin = uncontrolled BG results, dipyridamole + anti-platelet aggregates = increase bleeding potential, and lastly steroids + aspirin = increased risk for GI ulceration. Any easy way to remember this is HODS.

Aspirin side effects include hematologic (thrombocytopenia, anemia, bleeding), GI (N/V/D), GI bleeding, heartburn, and CNS (drowsiness, dizziness, confusion).

Clopidogrel side effects include GI (abdominal pain, dyspepsia, diarrhea, nausea), CNS (headache, dizziness, fatigue), and cardiovascular (chest pain, HTN, and edema).

Glycoprotein inhibitor side effects include bleeding, bradycardia, dizziness, edema, leg, and pelvic pain, along with edema.

Nursing priorities for a patient taking anti-platelet aggregates include clotting and pharmacology.

Indications include stroke risk reduction, stroke prophylaxis, MI, thromboembolic complications and disorders, along with PCI (angioplasty). Types of anti-platelet aggregates include glycoprotein inhibitors, aggregation inhibitors, aggregation inhibitors with vasodilation properties and miscellaneous (GAAM). Anti-platelet contraindications are plentiful and include drug allergies, thrombocytopenia, active bleeding, leukemia, traumatic injury, GI ulcer, vitamin K deficiency, and a recent stroke. Interactions include heparin, oral antidiabetic drugs, dipyridamole and steroids (HODS). Side effects are extensive but focus on CNS (headache, dizziness drowsiness), Heme (thrombocytopenia, bleeding), GI (N/V/D, bleeding), and Other (leg and pelvic pain).

You know now the important details regarding anti-platelet aggregates. Now, go out and be your best self today and as always, Happy Nursing!

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Exam 4

Concepts Covered:

  • Hematologic Disorders
  • Hematologic Disorders
  • Labor Complications
  • Respiratory Disorders
  • Proteins
  • Oncologic Disorders
  • Oncology Disorders
  • Cardiac Disorders
  • Medication Administration
  • Immunological Disorders
  • Renal Disorders
  • Eating Disorders
  • Liver & Gallbladder Disorders
  • Substance Abuse Disorders
  • Intraoperative Nursing
  • Infectious Respiratory Disorder
  • Pregnancy Risks
  • Upper GI Disorders
  • Microbiology
  • Shock
  • Postpartum Complications
  • Studying
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Emergency Care of the Trauma Patient
  • Integumentary Disorders
  • Central Nervous System Disorders – Brain
  • Neurological Trauma
  • Respiratory Emergencies
  • Emergency Care of the Cardiac Patient
  • Acute & Chronic Renal Disorders
  • Endocrine and Metabolic Disorders
  • Urinary System
  • Urinary Disorders

Study Plan Lessons

Sickle Cell Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Blood Transfusions (Administration)
Anti-Infective – Antivirals
Blood Transfusions (Administration)
Hemoglobin (Hbg) Lab Values
Hemoglobin (Hbg) Lab Values
Hemoglobin and Myoglobin
Red Blood Cell (RBC) Lab Values
Red Blood Cell (RBC) Lab Values
Nursing Care Plan (NCP) for Sickle Cell Anemia
Sickle Cell Anemia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Leukemia Case Study (60 min)
Nursing Care Plan (NCP) for Leukemia
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Nursing Care Plan (NCP) for Leukemia
Leukemia
Leukemia
Antimetabolites
Alkylating Agents
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Neutropenia
Hematocrit (Hct) Lab Values
Platelets (PLT) Lab Values
Chemotherapy Patients
Anti-Platelet Aggregate
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Thrombocytopenia
Platelets (PLT) Lab Values
Hematocrit (Hct) Lab Values
Oncology Module Intro
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Lymphoma
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Lymphoma
Anti Tumor Antibiotics
Brain Tumors
Head/Neck Assessment
Corticosteroids
Pediatric Oncology Basics
Head/Neck Assessment
Corticosteroids
Multiple Myeloma
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Acute Kidney Injury
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Liver Cancer
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Cirrhosis (Liver)
Nutrition (Diet) in Disease
Liver Function Tests
Liver/Gallbladder Module Intro
Cirrhosis Case Study (45 min)
Barbiturates
Anti-Infective – Antitubercular
Benzodiazepines
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Creatinine (Cr) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Furosemide (Lasix) Nursing Considerations
Anti-Infective – Antitubercular
Barbiturates
Enteral & Parenteral Nutrition (Diet, TPN)
Cholesterol (Chol) Lab Values
Atorvastatin (Lipitor) Nursing Considerations
Creatinine (Cr) Lab Values
Total Bilirubin (T. Billi) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Benzodiazepines
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Antimicrobial Vaccinations
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Fluid Volume Overload
Nursing Care Plan (NCP) for Hypovolemic Shock
Septic Shock (Sepsis) Case Study (45 min)
Nursing Care Plan (NCP) for Cardiogenic Shock
Hypovolemic Shock Case Study (OB sim) (60 min)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Cardiogenic Shock
Shock
Shock Module Intro
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Sepsis Concept Map
Sepsis Concept Map
Nursing Care Plan (NCP) for Diabetes Insipidus
Massive Transfusion Protocol
Disseminated Intravascular Coagulation Case Study (60 min)
Burn Injury Case Study (60 min)
Spinal Cord Injury Case Study (60 min)
Cerebral Perfusion Pressure Case Study (60 min)
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Metabolic Acidosis (interpretation and nursing diagnosis)
Burn Injuries
Disseminated Intravascular Coagulation (DIC)
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Fluid Volume Deficit
Nursing Care and Pathophysiology for Sepsis
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
ARDS causes Nursing Mnemonic (GUT PASS)
Nursing Care Plan (NCP) for Spinal Cord Injury
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Penetrating Thoracic Trauma
Renin Angiotensin Aldosterone System (RAAS)
Burn Injuries
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Dialysis & Other Renal Points
Blunt Chest Trauma
Spinal Cord Injury