Lecture Notes on Blood Thinners

Introduction

• Presenter: Nurse Mike from SimpleNursing.com
• Topic: Blood Thinners
• Promotion of NCLEX app with practice questions and detailed video rationales.

Types of Blood Thinners

• Small: Anti-platelets like Aspirin and Clopidogrel (Watergun)
• Medium: Anticoagulants like Heparin and Warfarin (Bazooka)
• Large: Thrombolytics like TPA and Altaplace (Atomic Bomb)

Anti-platelets: Aspirin and Clopidogrel

Indication

• Clot prophylaxis (prevention)
• Used in:
  • Heart and brain clots (MI, CVA prevention)
  • Narrowed arteries (ACS, TIA, PAD)
  • Post-stent or bypass (prevention of reocclusion)
  • Post-PCI (Percutaneous Coronary Intervention)

Mechanism of Action

• Prevent platelet aggregation (anti-clot)

Key Points Before Administration

• Assess Hemoglobin:
  • Less than 7: High bleed risk
• Assess Platelets:
  • Normal range: 150 – 400
  • Less than 150: Notify HCP
  • Less than 50: High bleed risk (thrombocytopenia)
• Priority action for low platelet count (<75,000 or <40,000):
  • Hold drug, question prescription, notify HCP

Aspirin Specific Notes

• Toxicity:
  • Signs: Tinnitus (ear ringing), hyperventilation
  • Treatment: Activated charcoal (blocks absorption)
• Contraindication:
  • Patients with hypoprothrombinemia (low clotting factors)
• Exam Tips:
  • Priority assessment for long-term use: Tinnitus
  • Tachycardia and hypotension not toxicity signs (could indicate bleed)

Glycoprotein or GP Receptor Inhibitors

• Example: L-cyxamab
• Use: Post-cardiac procedures (heart cath, coronary stent)
• Adverse Effects:
  • Severe thrombocytopenia and bleeding

Nursing Care

• Assessment:
  • Hemoglobin below 7: High risk
  • Platelets below 150: Caution
  • Less than 50: High risk (question prescriptions)
• Monitor for bleeding

Conclusion

• Encourage accessing full video and quiz bank
• Acknowledgement of the team of experts
• Promotion of YouTube channel subscription