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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Pharmy

Concepts Covered:

  • Adult
  • Medication Administration
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Anxiety Disorders
  • Depressive Disorders
  • Nervous System
  • Intraoperative Nursing
  • Gastrointestinal Disorders
  • Central Nervous System Disorders – Brain
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  • Prenatal Concepts
  • Learning Pharmacology
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Study Plan Lessons

ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atropine (Atropen) Nursing Considerations
Barbiturates
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Epoetin Alfa
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Fentanyl (Duragesic) Nursing Considerations
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Secure an IV (chevron, transparent dressing)
How to Remove (discontinue) an IV
Insulin
Hydralazine
Hydromorphone (Dilaudid) Nursing Considerations
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Mannitol (Osmitrol) Nursing Considerations
MAOIs
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
NG Tube Medication Administration
NG Tube Med Administration (Nasogastric)
Nitro Compounds
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Nystatin (Mycostatin) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Phenobarbital (Luminal) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
SubQ Injections
The SOCK Method – Overview
Tips & Tricks
Tips & Advice for Pediatric IV
Tips & Advice for Newborns (Neonatal IV Insertion)
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations