medicationaffectingcoagulations_110123

.docx

School

Rasmussen College *

*We aren’t endorsed by this school

Course

2571

Subject

Medicine

Date

Jan 9, 2024

Type

docx

Pages

3

Uploaded by DukeWalrusPerson540

Medications Affecting Coagulation Coumadin Heparin Lovenox Mode of Action Used in prophylaxis and treatment of venous thrombosis and thromboembolic events. Warfarin inhibits the vitamin K epoxide reductase complex 1 (VKORC1), an enzyme for activating the vitamin K available in the body (Patel et al., 2023) Heparin is an anticoagulant indicated for both the prevention and treatment of thromboembolic events such DVT and pulmonary embolism (PE). Heparin binds to several proteins; however it is binding to an antithrombin that is important , as this cause a surface change and inactivate thrombin (Huang et al., 2023 ) Enoxaparin is a low molecular weight heparin with a mean molecular weight. It's an indirect anticoagulant that binds serine protease inhibitors (Amamani et al., 2022). Indications - Reduction in the risk of death, recurrent myocardial infarction, and thromboembolic events(e.g ., stroke, systemic embolization) after myocardial infarction - prophylaxis and treatment of venous thrombosis and arising pulmonary embolism CONTRAINDICATIONs; - Hypersensitivity to warfarin or any component of formulations, recent or contemplated surgery of the eye, CNS or traumatic surgery resulting in large open surfaces - pregnancy because warfarin crosses the placenta, threatening abortion, eclampsia or preeclampsia(Patel et al., 2023) Infarction heparin is an anticoagulant indication for both the prevention and treatment of thrombotic event such as deep vein thrombosis (DVT) and PE, as well as AF (Huang et al., 2023) CONTRAINDICATION A patient should not receive heparin if platelet count is 100,000/mm or lower -Pt with history of heparin induced thrombocytopenia (Huang et al., 2023) -outpatient management of acute DVT, prophylaxis of DVT in hip replacement surgery, abdominal surgery, knee replacement (Amamani et al., 2022). CONTRAINDICATIONS History of heparin induced thrombocytopenia, active bleeding such as GI bleed, history of hypersensitivity to benzyl alcohol in neonates (Amamani et al., 2022). Dosage/Route PO q.d. IV SQ SQ IV- should never be mixed or co-administered with other medication (Amamani et al.,
2022). Side Effects Adverse side effects can include bleeding and significant hemorrhage (GI bleed, hematemesis, intraocular bleeding, hemarthrosis), nausea, vomiting, abdominal pain, bloating, altered sense of taste. (Patel et al., 2023) bleeding , injection site reactions,blood in the urine, stool, petechial rash, hyperkalemia, (alopecia, osteoporosis, osteopenia with chronic heparin) (Huang et al., 2023 ) Bleeding is the most common adverse effect, heparin induced thrombocytopenia, nausea, vomiting, confusion, headache, GI bleed, osteoporosis, rectus sheath hematoma, hepatotoxicity (Amamani et al., 2022). Labs to Monitor Prothrombin time (PT)and the International normalized ratio INR. PT (10-20 seconds) INR (2.0-3.0 (Patel et al., 2023) Therapeutic monitoring for heparin includes activated partial thromboplastin time (aPTT) and activated clotting time (ACT) (Huang et al., 2023 ) PTT (25-35 seconds) The patient should be monitored closely 1 for signs and symptoms of bleeding (advance age, female sex, and concomitant use of antiplatelet drugs are the most common risk factors of bleeding (Amamani et al., 2022). PTT, CBC, Antidote Toxicity is assessable through signs and symptoms of bleeding as well as determination of supratherapeutic INR level especially above 5.0. When managing toxicity the initial step is to discontinue and administer vitamin K (Patel et al., 2023) Protamine sulfate Protamine sulfate Patient teaching Teach the importance of complying with prescribed dosage and follow up appointments. Tell pt. and family members to prevent bleeding and watch for signs of bleeding. Teach pt. to use an electric razor when shaving and to use Instruct pt. to report all drug and food allergies. Instruct pt. and family report all adverse reactions. Advise pt and family to watch for immediate signs and symptoms of bleeding. Instruct pt. and family to watch for signs of bleeding or abnormal bruising and notify pcp immediately. Teach pt. to avoid OTC drugs containing aspirin.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
  • Access to all documents
  • Unlimited textbook solutions
  • 24/7 expert homework help