Hi. In this video, we are going to continue covering some hematologic medications.
Specifically, I'll be talking about a few more anticoagulant and antiplatelet medications.
So let's start off by talking about factor Xa inhibitors. Medications that fall within this
class include rivaroxaban as well as apixaban, which is Eliquis. So these medications are used to
prevent a DVT, a stroke, or a PE in patients who have atrial fibrillation.
They work by selectively inhibiting factor Xa, which helps to block the coagulation cascade.
So the way I remember at least one of these medications, rivaroxaban,
it looks like river. So if you take rivaroxaban, it will help your blood flow like a river
because it's going to thin it out. So side effects, bleeding is the
big one to remember here. Anytime we have an anticoagulant, bleeding is always going to be
a risk if we thin the blood too much, right, we do too much anticoagulation.
Another side effect is possible elevated liver enzymes with this medication.
In addition, this class of medication carries a black box warning because if you abruptly
discontinue to use this medication, it places the patient at higher risk for thrombotic events.
So when your patient is on this medication, you want to monitor their liver function because
of the risk of elevated liver enzymes. You're also going to want to monitor their hemoglobin
and hematocrit during therapy. Alright. Now let's talk about
platelet aggregation inhibitors or antiplatelets. So the two medications that I'd be familiar with,
that fall under this class, include clopidogrel and abciximab. So abciximab is the medication
that's spelled kind of funky. It's A-B-C and then so on which makes you wonder how they
come up with these names. But that's what it is. So these medications are used to prevent an MI
or a stroke in patients who have acute coronary syndrome.
They work by inhibiting platelet aggregation. So when I think about the medication clopidogrel,
it looks like clop. The first of part of it, so I think about a horse clopping on platelets and
preventing them from aggregating. So that's my little, silly way of remembering what
clopidogrel does, what it's mode of action is. So side effects with both of these medications:
bleeding, right. Any time we have a anticoagulant or an antiplatelet,
bleeding is going to be a key side effect. With abciximab, you can also have
hypotension tension as well as dysrhythmias and with clopidogrel,
GI upset and rash are other side effects as well. So if your patient is on one of these medications,
you are definitely going to want to assess for bleeding. And then, for abciximab,
you're also going to want to pay attention to your patient's EKG and their vital signs because of
the side effects of hypotension and dysrhythmias. Alright, now let's talk about thrombin inhibitors.
Two medications that fall within this class include argatroban and dabigatran. These
medications can be used to treat a DVT, a PE, they can help prevent a stroke, and they are also used
with HIT or heparin-induced thrombocytopenia. Their mode of action is to block thrombin
receptors which helps to prevent the activation of clotting factors and the formation of a clot.
The key side effect with both of these medications is bleeding.
In addition, with argatroban, hypotension is a possible side effect, and with dabigatran,
GI upset and angioedema are also possible side effects.
So the way I remember these medications and the key side effect of bleeding is I say, "There is no
time to argue. You can't just dab at the blood. You need to hold pressure to stop the bleeding
from argatroban or dabigatran. So again, key side effect is bleeding and anytime your patient is
bleeding, you need to hold steady pressure on that area in order to stop the bleeding.
So the key thing you're going to be doing when a patient is on this therapy is assess
for bleeding just like we've done with these other anticoagulants that we've talked about.
Okay. In my next video, we will be wrapping up our hematologic medications. We'll be talking about a
hemostatic agent as well as a thrombolytic medication, and then we'll also be covering
erythropoiesis, growth factors, and leukopoietic growth factors as well. So hang in there with me!