1 / 13

PTP 546 Module 6 Cardiovascular Pharmacology: Part II

PTP 546 Module 6 Cardiovascular Pharmacology: Part II. Jayne Hansche Lobert, MS, RN, ACNS-BC, NP. Cardiovascular Pharmacology. Drugs used to treat excessive clot formation Anticoagulants (only stop you for making new clots, they do NOT break down clots) Heparin

ania
Télécharger la présentation

PTP 546 Module 6 Cardiovascular Pharmacology: Part II

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. PTP 546Module 6Cardiovascular Pharmacology: Part II Jayne Hansche Lobert, MS, RN, ACNS-BC, NP Lobert

  2. Cardiovascular Pharmacology • Drugs used to treat excessive clot formation • Anticoagulants (only stop you for making new clots, they do NOT break down clots) • Heparin • Low Molecular Weight Heparin (Lovenox) • Warfarin (Coumadin) • Antithrombotics • Aspirin • Clopidogrel (Plavix) • Thrombolytics • Streptokinase (Streptase) Lobert

  3. Cardiovascular Pharmacology • Anticoagulant • Ex: Heparin (special spot, niche for action) • Action: potentiates antithrombin renders clotting factors inactive; inhibits synthesis and function of clotting factors • Therapeutic Effect: prevents clot formation; prevents extension of existing venous thromboembolism (VTE prophylaxsis) • Side Effects: Bleeding (gums, bruises, urine, stool, internal bleeding) ; thrombocytopenia (platelet reduction in blood, so huge potential to bleed); HIT increased thrombosis (opposite effect, freak thing) • Note: requires extensive monitoring of labs (PTT) • For PT it may mean limiting exercise: look at PPT and platelet count. Lobert

  4. Cardiovascular Pharmacology • Anticoagulant • Ex: Low Molecular Weight Heparin Enoxaprin (Lovenox-done in home setting, super expensive so need insurance); Dalteparin (Fragmin) • Action: Inhibits synthesis of clotting factors • Therapeutic Effect: prevention of clot formation and prevention of extension of an existing venous thromboembolism • Side Effect: Bleeding- • Requires less monitoring Lobert

  5. Cardiovascular Pharmacology • Anticoagulant • Ex: Fondaparinux (Arixtra) • Action: inhibits clotting factor Xa prevention of clot formation • Therapeutic Effect: prevention of venous (VTE) thromboembolism for patients at risk ex: post op orthopedic surgery; immobile • Side Effects: Bleeding Lobert

  6. Cardiovascular Pharmacology • Anticoagulant • Ex: Warfarin (Coumadin)-super common/easy • Action: inhibits vitamin K decreases synthesis of clotting factors II, VII, IX, X • Leafy greens could not be processed so increased rate of clotting. • Therapeutic Effect: long term prevention of blood clots in persons with valve replacements, atrial fibrillation, DVT history • Side Effects: bleeding • Pts. are commonly admitted to the hospital for Coumadin toxicity • Note: requires long term lab analysis of PT/INR • Pro-time/International normalized ratio (want INR to be 2-3 seconds, lower if A-Fib) Lobert

  7. Cardiovascular Pharmacology • Antithrombotic Drugs • Ex: Aspirin • Action: suppress of proaggregation substances inhibition of platelet aggregation • Therapeutic Effect: prevention of myocardial infarction, prevention of cerebral ischemia/stroke • Side Effects: gi upset, gi bleeding; tinnitus at high doses • Baby aspirin: 81mg • Monitor Hgb: normal (12 females,14-16 males), Lobert

  8. Cardiovascular Pharmacology • Antithrombic Drugs: ADP Receptor Inhibitors • Ex: Clopidogrel (Plavix), used to prevention of MI when have a high risk • Action: inhibits ADP (a compound that increases platelet activity) • Therapeutic Effect: prevention of myocardial infarction; ischemic stroke and peripheral vascular diseases • Side Effects: Bleeding Lobert

  9. Cardiovascular Pharmacology • Thombolytics “take away a clot” • Ex: Streptokinase (Streptase);t-PA (alteplase) • Action: converts plasminogen to plasmin the enzyme which breaks down clots • Therapeutic Effect: treatment of ischemic strokes, myocardial infarctions; treatment of peripheral arterial occlusions; treatment of occluded venous access devices • Have a therapeutic window, when given 1hr inside window then reduce death rate by 50%. • Side Effects: intracerebral hemorrhage; bleeding Lobert

  10. Cardiovascular Pharmacology • Agents used to treat hyperlipidemia • HMG-CoA Reductase Inhibitors (Statins) • Simvastatin (Zocor) • Lovastatin (Mevacor) • Fibric Acid Agents • Gemfibrozil (Lopid) • Fenofibrate (Tricor) • Cholesterol Absorption Inhibitor • Ezetimbe (Zetia) Lobert

  11. Cardiovascular Pharmacology • Statins • Ex: Lovastatin (Mevacor); Simvastatin (Zocor) • Action: inhibits critical enzyme for cholesterol production  decrease cholesterol production • Therapeutic Effect: decrease levels of LDL and triglycerides with moderate increase in HDL (HDL can also be increased with exercise) • Side Effects: nausea, cramping, myopathies-muscle pain, rhabdomyolysis-kidney faliure, liver dysfunction • Labs 6 to 12 months to check liver enzymes Lobert

  12. Cardiovascular Pharmacology • Fibric Acid Agents • Ex: Gemfibrozil (Lopid); Fenofibrate (Tricor) • Action: mechanism is unknown • Therapeutic Effects: decreases triglyceride levels, increased HDL • Side Effects: abdominal pain, fatigue, nausea and vomiting, liver dysfunction Lobert

  13. Cardiovascular Pharmacology • Cholesterol Absorption Inhibitors • Ex: Ezetimibe (Zetia) • Action: inhibits cholesterol absorption production in the GI tract • Therapeutic Effect: reduces LDL & triglycerides; increased HDL • Side Effects: gi distress, abdominal pain Lobert

More Related