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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Pharm

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  • Microbiology
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  • Central Nervous System Disorders – Brain
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Study Plan Lessons

12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
Anti-Infective – Antifungals
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Basics of Calculations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Catheter Selection (gauge, color)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin
Injectable Medications
IM Injections
Hydromorphone (Dilaudid) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Bariatric: IV Insertion
Anti-Platelet Aggregate
Anesthetic Agents
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs