NURS 3220 Lecture Notes - Lecture 22: Hypersensitivity, Streptokinase, Vitamin K Antagonist
Document Summary
Hemostasis: stage 1: formation of platelet plug, platelet aggregation, stage 2: coagulation, intrinsic coagulation pathway, extrinsic coagulation pathway, keeping hemostasis under control, physiologic removal of clots - plasmin. 2 mechanisms of action: 1 inhibit the synthesis of clotting factors, 2 inhibit the activity of clotting factors. Heparin (unfractionated: enhances antithrombin, rapid-acting anticoagulant, administered by injection only, iv. Uses: preferred anticoagulant during pregnancy and when rapid anticoagulation is required, pulmonary embolism (pe, stroke evolving, massive deep venous thrombosis (dvt, open heart surgery, renal dialysis, low-dose therapy postoperatively, disseminated intravascular coagulation (dic, adjunct to thrombolytic therapy. Adverse effects: hemorrhage, heparin-induced thrombocytopenia, hypersensitivity reactions. Contraindicated: thrombocytopenia, uncontrollable bleeding, during and immediately after surgery of the eye, brain, or spinal cord. Heparin preparations composed of molecules that are shorter than those found in unfractionated heparin. Uses: prevention of dvt following surgery, including replacement of hip, knee, treatment of established dvt, prevention of ischemic complications, patients with unstable angina, non q-wave mi, and stemi.
