160 Lepirudin

Question 1

Therapeutic classification

Answer 1

Anticoagulant

Question 2

Pharmacologic classification

Answer 2

Direct thrombin inhibitor

Question 3

Mechanism of action

Answer 3

Directly inhibits action of thrombin without requiring intermediate step of antithrombin III inhibition

Question 4

indications

Answer 4

Heparin induced thrombocytopenia

Question 5

precautions

Answer 5

Severe HTN, recent trauma, recent surgery, intracranial hemorrhage, bacterial endocarditi, renal impairment

Question 6

contraindications

Answer 6

active bleeding, aPTT ratio greater than 2.5

Question 7

drug interactions

Answer 7

potentiated affects with oral anticoagulents, bleeding with drugs that inhibit platelet aggregation, ginger, garlic, green tea, feverfew, ginkgo

Question 8

pregnancy category

Answer 8

B

Question 9

adverse effects

Answer 9

wound bleeding, epistaxis (nose bleed), hematuria, vaginal bleeding, GI bleeding, hypersitivity, abnormal bleeding

Question 10

nursing considerations

Answer 10

health Hx, baseline blood tests, moniter aPTT, collect blood 30 min prior to dose, moniter for bleeding, no oral anticoagulants

Question 11

teaching

Answer 11

report bleeding, avoid accident prone activities, no other drugs or supplements, immediately report pregnancy, no breast feeding

Question 12

Antidote

Answer 12

None

Question 13

common route

Answer 13

IV