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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  • Shock
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Study Plan Lessons

Sepsis Concept Map
Shock
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Surgical Incisions & Drain Sites
Surgical Prep
Surgical Counts for Certified Perioperative Nurse (CNOR)
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Tension and Cluster Headaches
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
Thoracentesis
Thrombocytopenia
Thrombolytics
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Vancomycin (Vancocin) Nursing Considerations
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Wound Infections for Certified Emergency Nursing (CEN)
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)
Wound Classification for Certified Perioperative Nurse (CNOR)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
02.14 Shock Stages for CCRN Review
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
ACE (angiotensin-converting enzyme) Inhibitors
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Adjunct Neuro Assessments
Admissions, Discharges, and Transfers
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airway Suctioning
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Amputation
Amputation Concept Map
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
Anesthetic Agents
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antitubercular
Anti-Platelet Aggregate
Anticonvulsants
Antidiabetic Agents
Antimetabolites
Antineoplastics
Antinuclear Antibody Lab Values
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
ASA (Aspirin) Nursing Considerations
Aspiration for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma for Certified Emergency Nursing (CEN)
At Risk for Gout Nursing Mnemonic (MALE)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Azithromycin (Zithromax) Nursing Considerations
Barriers to Health Assessment
Blood Flow Through The Heart
Blunt Chest Trauma
Bowel Obstruction Concept Map