Developed by: Dawn Johnson, RN, MSN, Ed

Internally and externally Prevent bleeding from wounds which

could lead to shock or even death

Injured vessel constricts to slow blood flow

Platelets adhere to injured area and aggregate, plugging damaged vessel

Coagulation cascade occurs thus forming insoluble fibrin strands which slows blood flow more

Injured cells release prothrombin activator

Prothrombin activator changes prothrombin to thrombin

Thrombin changes fibrinogen to fibrin Fibrin forms an insoluble web over injured

area which stops blood flow

Anticoagulants Thrombolytics Hemostatics

Inhibiting specific clotting factors in the coagulation cascade

Diminishing the clotting action of platelets

Both ways increase the time to form clots

Dissolve life-threatening clots

Promote formation of clots Inhibit removal of fibrin

Examples - heparin (Heplock), warfarin (Coumadin)

Mechanism of action - inhibit specific clotting factors which interfere with coagulation cascade in order to prevent formation or enlargement of clot

Primary use - thromboembolic disease; prevent formation of clots in veins

Adverse effects - abnormal bleeding

Example - ticlopidine (Ticlid) Mechanism of actions

Aspirin: inhibits thromboxane2, which prevents aggregation of platelets

ADP receptor blockers: interfere with platelet plasma membrane, which prevents platelet aggregation

Glycoprotein IIb/IIIa inhibitors: glycoprotein IIb/IIIa enzyme inhibited which prevents platelet aggregation

Primary uses - prevent clot formation in arteries

Adverse effects - abnormal bleeding; reduce number of neutrophils

Example - alteplase (Activase) Mechanism of action - convert plasminogen to

plasmin which causes fibrin to degrade, then preexisting clot dissolves

Primary uses - acute MI, pulmonary embolism, acute ischemic CVA, DVT, arterial thrombosis, coronary thrombosis, clear thrombi in arteriovenous cannulas and blocked IV catheters

Adverse effects - abnormal bleeding; contraindicated in patients with active bleeding or recent trauma

Example - aminocaproic (Amicar) Mechanism of action - prevent fibrin from

dissolving, which enhances stability of the clot

Primary use - prevent and treat excessive bleeding from surgical sites

Adverse effects - none listed

Provide essential building blocks for RBC production.

They do so by increasing hemoglobin which is necessary for oxygen transportation

Iron Vitamin B12 Folic Acid

Used to treat the most common form of anemia-iron defieciency.

One function of iron-production of hemoglobin.

Treatment is usually 6 months Parenteral iron therapy is used for

patients who can’t absorb oral preparations, aren’t compliant with oral treatment, or have bowel d/o

Iron is reduced by antacids as well as foods such as coffee, tea, eggs, and milk.

Other drug interactions are: Tetracycline or any of the cycline drugs, methlydopa, ciprofloxacin, oloxacin, chloramphenicol, and pencillamine may be reduced.

Cimetidine and other histamine2-receptor antagonists may decrease GI absorption of iron.