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Chapter 19 Agents Affecting Blood Clotting
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Chapter 19
Agents Affecting Blood Clotting
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 2
Blood Clotting
Thromboemboli Cause many deaths per year
Anticoagulants Prevent the formation of coagulants
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 3
Anticoagulant Agents
Inhibit the formation of clots Heparin
Found in mast cells
Action Inhibit the clotting process
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 4
Heparin
Heparin action Indirectly interferes with the conversion of
prothrombin to thrombin The deficiency of thrombin prevents the
conversion of fibrinogen to fibrin
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 5
Heparin
Destroyed if given orally Administered via IV infusion
No intramuscular injections Administered subcutaneously
Longer acting form No intramuscular injections
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 6
Heparin: Side Effects
Hemorrhage Allergy Antidote
Protamine sulfate Caution
Do not administer to clients with coagulation disorders
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 7
Low Molecular Weight Anticoagulant
Related to heparin Minor risk for bleeding
Does not affect the action of thrombin in the clotting cascade
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 8
Low Molecular Weight Anticoagulant
Example: enoxaparim (Lovenox)
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 9
Oral Anticoagulants
Warfarin (Coumadin) Inhibits blood clotting by interfering with
the synthesis of vitamin K-dependent clotting factors
Close client monitoring Dosage is individualized International normalized ratio
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 10
Antiplatelet Agents
Action: inhibit the aggregation of platelets
Treat clients who have had cerebrovascular accidents or myocardial infarctions
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 11
Antiplatelets
Examples Aspirin Abciximab (ReoPro) Clopidogrel bisulfate (Plavix)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
19 - 12
Thrombolytic Agents
Action Convert plasminogen to enzyme
fibrinolysin; fibrinolysin dissolves clots Example
Streptokinase (IV) Caution
Hemorrhage
