Antiplatelet and Anticoagulant Pharmacology for the Laboratory Professional

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Author: Kyle D. Mills, DO, MLS(ASCP)SH
Reviewer: Katie Blain, PharmD, MPH; Margaret Reinhart, MS, MT(ASCP)

This course will reintroduce older pharmacologic therapies, as well as introduce new therapies. The course will begin with a review of hemostasis physiology, continue with an overview of antiplatelet and anticoagulant pharmacology as it stands today, and end with a review of coagulation assays that may be seen in the clinical laboratory.

Continuing Education Credits

Objectives

  • Identify the various components of the hemostatic system as being either promoters or inhibitors of coagulation.
  • Differentiate between the mechanism and purpose of primary coagulation, secondary coagulation, fibrinolysis, and natural coagulation inhibition.
  • Generalize the mechanism of action of various pharmacologic agents used to treat hemostatic disorders.
  • Predict which laboratory assay(s) is(are) used to monitor the effectiveness of a given hemostatic medication based on that medication's mechanism of action.
  • Recognize the potential toxicities of pharmacologic agents used in the treatment of hemostatic disorders.

Course Outline

  • Course Information
      • Introduction
  • Review of Hemostasis Physiology
    • Basic Definitions and Components
      • Basic Definitions and Components
      • Overview of Thrombosis
    • Primary Coagulation
      • Primary Coagulation
      • Platelet Production
      • Thromboxane A2 and ADP are secreted when platelets become activated.
    • Secondary Coagulation
      • Secondary Coagulation
      • The Coagulation Factors
      • Secondary Coagulation: Coagulation Cascade
      • Coagulation Pathway Summary Chart
      • Which of the following functions to reinforce the platelet plug at the site of bleeding?
      • Identify the following coagulation factors as being part of either the intrinsic or extrinsic pathway of the coagulation cascade.
    • Coagulation Inhibition and Fibrinolysis
      • Overview of Coagulation Inhibition and Fibrinolysis
      • Three Natural Inhibitors of Coagulation
      • Fibrinolysis
      • Which of the following is a natural inhibitor of coagulation?
  • Antiplatelet and Anticoagulant Pharmacology
    • Overview
      • Overview of Hemostasis and Thrombosis Pharmacology
    • Anticoagulants
      • Heparins: Heparin and Low-Molecular-Weight Heparin
      • Clinical Correlation: Heparin-Induced Thrombocytopenia (HIT)
      • Warfarin
      • Table 2: Heparin vs. Warfarin Summary Chart
      • Direct Factor Xa Inhibitors
      • Direct Thrombin Inhibitors
      • What is the autoantibody implicated in heparin-induced thrombocytopenia (HIT)?
      • Identify if the property listed is applicable to heparin or warfarin.
    • Antiplatelet Medications
      • Aspirin and other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
      • GP IIb/IIIa Inhibitors
      • ADP Receptor (P2Y12 Receptor) Inhibitors
      • Aspirin produces an irreversible inhibition of platelets.
    • Thrombolytics
      • Alteplase and Streptokinase
      • In a patient experiencing a stroke, tPA can be used for up to how many hours after the onset of symptoms?
    • Coagulation Agonists
      • Overview of Coagulation Agonists
      • Coagulation Factors and Desmopressin
      • Clinical Correlation: Hemophilia A and B
      • Clinical Correlation: von Willebrand Disease (vWD)
      • Vitamin K
      • Which of the following are vitamin K-dependent factors?
  • References
      • References

Additional Information

Level of Instruction: Intermediate

Intended Audience:  Medical laboratory scientists, medical technologists, and technicians. This course is also appropriate for medical laboratory science students, pathology residents, and other healthcare personnel who are responsible for prescribing and administering antiplatelet and anticoagulant medications.

Author Information: Kyle D. Mills, DO, MLS(ASCP) SH, completed his professional medical education at the University of Pikeville - Kentucky College of Osteopathic Medicine in Pikeville, Kentucky, in 2018. He is currently pursuing residency in internal medicine at the University of Louisville in Louisville, Kentucky. Dr. Mills also holds a Bachelor of Health Science in Clinical Laboratory Sciences degree from the University of Kentucky and is an American Society for Clinical Pathology (ASCP) certified Medical Laboratory Scientist (MLS) and Specialist in Hematology (SH). Before attending medical school, Dr. Mills worked on the laboratory bench as a generalist and led a medical laboratory technician program.

Reviewer Information: Katie Blain, PharmD, MPH, is a pharmacist with the Appalachian Regional Healthcare health system in Eastern Kentucky and Southern West Virginia. Dr. Blain currently serves as the Kentucky Pharmacists Association (KPhA) New Practitioner Committee Chair. She completed an American Society of Health System Pharmacy (ASHP) accredited community pharmacy residency program with Sullivan University College of Pharmacy and Walgreens Co. in Louisville, Kentucky. Dr. Blain received her Doctor of Pharmacy and Master of Public Health degrees from the University of Kentucky.  
 
Reviewer Information: Margaret Reinhart MS, MLS(ASCP), is the former MLS Program Director and Senior lecturer in Biological Sciences at the University of the Sciences in Philadelphia (now St. Joseph's University), where she taught hematology, clinical immunology, parasitology, and other related courses. She is also an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia, PA. She holds a Master's Degree in Biology and Health Care Administration. 

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