Term
| What is the gold standard for coagulation? |
|
Definition
|
|
Term
| What pathway(s) does heparin work on? |
|
Definition
*Intrinsic
*Common Pathway |
|
|
Term
| What lab values are affected by Heparin? |
|
Definition
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|
Term
| The presence of what factor is required for Heparin to work? |
|
Definition
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|
Term
|
Definition
| *Increases the effectiveness of heparin by 1000 fold |
|
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Term
| What is the onset of heparin and when is someone said to be fully heparinized? |
|
Definition
*Onset: immediate
*fully heparinized: 3 minutes
-ACT should be 400-450 |
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Term
| What is the dose of heparin? What is the half life? |
|
Definition
*50-300u/kg
*60-90 minutes |
|
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Term
| What are the side effects of heparin? |
|
Definition
*Hemorrhage
*Thrombocytopenia
*Hypotension (Less common) |
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|
Term
| What is the reversal for heparin? What is the most common reason for heparin not working? |
|
Definition
*Protamine Sulfate
*AT III Deficiency |
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|
Term
| What is protamine sulfate used for? |
|
Definition
|
|
Term
| What is the dose of Protamine sulfate for heparin reversal> |
|
Definition
|
|
Term
| How does Protamine sulfate inactivate Heparin? |
|
Definition
*Neutralization Reaction
*Forms a complex |
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|
Term
| What is the onset and duration for Protamine Sulfate? |
|
Definition
*30 sec - 1 minute
*Duration: 2 hours |
|
|
Term
| What can occur with rapid IV administration of Protamine Sulfate? |
|
Definition
*A huge histamine release
-Hypotension
-Bronchospasm
-Tachycardia |
|
|
Term
| Which patients are at an increased risk for allergy? |
|
Definition
*Pts allergic to fish
*Past vasectomy
*Previous exposure to protamine
*NPH insulin use |
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|
Term
| What is the MOA of desmopressin acetate? |
|
Definition
| *Increases plasma levels of Factor VIII by causing release of vWF from endothelial cells |
|
|
Term
| What is the MOA of aspirin? |
|
Definition
| *Irreversible acetylation of cyclooxygenase |
|
|
Term
| What are the effects of aspirin and what are the anesthetic implications? |
|
Definition
*Impaired platelet aggregation
*May prolong PT time
*Irreversibly binds for life of platelet
-7-10 days
*If pt is on ASA and emergency surgery is necessary, administer platelets |
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|
Term
| What is the MOA of NSAIDS? |
|
Definition
| *Temporary inhibition of COX pathway |
|
|
Term
| What are the effects of NSAIDS and anesthetic implications? |
|
Definition
*Platelet aggregation is impaired
*No reversal
*Medications should be stopped 72 hours prior to surgery |
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