blood flash cards

8/13/2019 blood flash cards

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Anticoagulants

(Parenteral)

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: Heparin — Others: enoxaparin, tinzaparin

• Intrinsic factors and thrombin conversion are inhibited by heparin

Therapeutic Uses: • Evolving stroke, E, !I, "#$ • "%ring pregna

• &d'%nct d%ring s%rgery, dialysis, abdominal s%rgery, or 'oint replacem• "isseminated intravasc%lar coag%lation

Adverse Effects: • Hypersensitivity reaction (chills, fever, %rticaria)

• Hemorrhage * heparin +" (treat protamine sulfate)

• Heparin-ind%ced thrombocytopenia (stop if .$ / 011,1112cc)

Contraindications/Precautions: • 3I: .$ or %ncontrollable bleeding

• 3I: 4%rgery of eye, brain, spinal cord5 regional anesthesia5 l%mbar p%nct

Interactions: • &nti-platelet agent additive risk of bleeding

•

Education: • !onitor a$$ levels 67-8h and then 6" (81-91 sec)

•


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Treatment of Hearin !"

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: rotamin

• inds ;ith heparin and forms a non-coag%lating complex

Therapeutic Uses: • &ntidote to severe heparin overdose

•


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Anticoagulant(!ral)

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: ;arfarin (3o

• &ntagonizes vitamin > 2 prevents synthesis of 7 intrinsic factors ? proth

Therapeutic Uses: • revention of veno%s thrombosis

• revention of thrombi in &-fib and ;ith prosthetic heart valves

Adverse Effects: • Hemorrhage ($x ;ith vitamin >)

•

Contraindications/Precautions: • Pregnancy (X)

• 3I: 4%rgery of eye, brain, spinal cord5 regional anesthesia5 l%mbar p%nct

•3I: .$ co%nts, %ncontrolled bleeding, vit@ > A, liver problems, alcoh

Interactions: • Heparin, aspirin, glucocorticoids bleeding

• Acetaminophen, sulfonamides, parenteral cephalosporins, ASA B;a

• Phenobarbital, carbamazepine, phenytoin, OC, vitamin K ;arfarin

Education: • $ therape%tic level D 09-7 sec (normal D 00-0@= sec)

•

+nset takes 9-0 hrs, f%ll effect takes -= days


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Treatment of #arfarin !"

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: #itamin > (hyton

• romote synthesis of intrinsic factors and prothrombin

Therapeutic Uses: • #itamin > deficiency

•


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Antilatelets

N203 ATI (Unit 7

Hematologic Sy


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Expected

Action:

Proto: &spirin — Others: ticlopidine ($iclid), clopidogrel

dipyridamole (ersantine), abciximab (<

• revent platelet cl%mping by inhibiting arterial clotting enzymes and fac

Therapeutic Uses: • rimary prevention of ac%te !I • revention o

• revention of reinfarction

• &c%te coronary syndromes (abciimab and tirofiban !Aggrastat")

Adverse

Effects:

• FI effects (conc%rrent I 2 enteric-coated 2 take food)

• Hemorrhagic stroke

Contraindications/Precautions: • regnancy (")

Interactions: •

• !edications that enhance bleeding additive risk for bleeding

Education: •

• &4& (90 mg) for prevention 2 &4& (= mg) d%ring initial ac%te !I epi


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T$rom%olytic &e'ications

N203 ATI (Unit 7

Hematologic Sy


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Iron Prearations

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: Gerro%s s%lfate — Others: Iron

• Increase iron level for


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itamin 12(*yanoco%alamin)

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: #itamin 12 (cyanocob

• Lecessary to convert folate (re%ired for "L& prod%ction) from inactive

Therapeutic Uses: •

$reatment of 12 deficiency• !egaloblastic (macrocytic) anemia related to 12 deficiency

Adverse Effects: •

• Hypokalemia *


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+olic Aci'

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: Go

• Golic acid is essential in "L& prod%ction ? erythropoiesis (


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Hematooietic ,rot$ +actors

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: Epoetin alfa (Epogen, rocrit) — Others: darbepo

• &ct on bone marro; to


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,ranulocyte *olonyStimulating +actor

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: filgrastim (Le%pogen) — Others: pegfilgrastim (L

• !edications stim%late bone marro; to prod%ction of ne%trophils@


infection risk ;ith ne%tropenia (e@g@ cancer)Adverse Effects: • one pain

• .e%kocytosis: dose 2 interr%pt treatment if M3 N =1,1112cc, &L3 N

1,1112cc, or platelets N =11,1112cc@

Contraindications/Precautions: • 3I: 4ensitive to () coli proteins

•

Interactions: •

•

Education: • *ilgrastim sho%ld not be agitated nor mixed

• !onitor 33 x per ;eek


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,ranulocyte &acro$age*olony Stimulating +actor

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: Proto: 4argramostim (.

• prod%ction of M3s in bone marro;


• Gacilitates recovery of bone marro; after marro; transplant@

Adverse Effects: • "iarrhea, ;eakness, rash, malaise, and bone pain (call

• .e%kocytosis, thrombocytosis: O if M3N=1,111, &L3N1,111, .$N=

Contraindications/Precautions: • 3I: &llergic to yeast prod%cts

• 3a%tion disease, hypoxia, peripheral edema, ple%ral2pericardial eff%s

Interactions: •

•

Education: • Sargramostim sho%ld not be agitated nor mixed ;ith other

•


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Expected Action: Proto: oprelvekin (Interle%kin 00, L

• Increases prod%ction of platelets@

Therapeutic Uses: • thrombocytopenia myelos%ppressive chemotheAdverse Effects: • Gl%id retention (peripheral edema, dyspnea on exertio

• "ysrhythmias • 3on'%nctival in'ection, transient bl%rring, and papill

Contraindications/Precautions: •

•

Interactions: •

•

Education: • $reat for 0 days or %ntil .$ N =1,111

•


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#$ole loo'

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: • Increases circ%lating blood vol%me

Therapeutic Uses: • &c%te blood loss, extensive b%rns, dehydration, shoc

Adverse Effects: • 4epsis (c%lt%re, antibiotics, I# fl%ids, vasopressors, st

• &c%te hemolytic rxn (fever, tachycardia, hypotension): #4 6=m for 0=m

• Gebrile nonhemolytic rxn (most common) (fever, headache): #4 6=m fo

• &naphylaxis: #4 6=m for 0=m P I! or I# epinephrine

• !ild allergy: If respiration %ncompromised, antihistamines and restart

• 3irc%latory overload: lace %pright 2 + and di%retics 2 slo;er rate

Education: •


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Pac.e' /*s

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: • U of


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Platelet *oncentrate

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: • platelet co%nt

Therapeutic Uses: • $hrombocytopenia (/ 1,1112cc)

• &ctive bleeding (platelets / 91,1112cc)

Adverse Effects: • 4epsis (c%lt%re, antibiotics, I# fl%ids, vasopressors, st

• Gebrile nonhemolytic rxn (most common) (fever, headache): #4 6=m fo

• !ild allergy: If respiration %ncompromised, antihistamines and restart

Education: •


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+res$ +roen Plasma

N203 ATI (Unit 7

Hematologic Sy

E t d A ti •


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Expected Action: •


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P$erese' ,ranulocytes

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: •


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Al%umin

N203 ATI (Unit 7

Hematologic Sy


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Expected Action: • Expands circ%lating blood vol%me by oncotic press%re

Therapeutic Uses: • Hypovolemia • %rns • &d%lt respiratory distre

• Hypoalb%minemia • 3ardiop%lmonary bypass s%rger

• Hemolytic disease of the ne;born

Adverse Effects: •

•

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