Chapter 19 Agents Affecting Blood Clotting

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved 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 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 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 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 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 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 Low Molecular Weight Anticoagulant Example: enoxaparim (Lovenox) (continued)

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved 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 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 Antiplatelets Examples  Aspirin  Abciximab (ReoPro)  Clopidogrel bisulfate (Plavix)

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Thrombolytic Agents Action  Convert plasminogen to enzyme fibrinolysin; fibrinolysin dissolves clots Example  Streptokinase (IV) Caution  Hemorrhage