Anti-Coagulant Med

Question 1

INR Ranges

Answer 1

Normal range for healthy person is 0.8-1.2
Normal range for Warfarin patient is 2.0-3.0

> INR is the thinner the blood is which means the patient is at risk of excessive bruising, haemorrhaging etc.
INR 8.0 means the blood will take 8 times longer than normal blood to clot.

Question 2

What is Warfarin

Answer 2

Warfarin is an Anti-Coagulant that prevents the reduction of Vitamin K which is needed for the clotting process.
The Antidote is Vitamin K.
It needs regular monitoring to administer the appropriate dose until stabilised. This monitoring is called International Normalisation Ratio (INR) blood test.
Oral Medications include:
Apixaban
Rivaroxaban
Dabigatran

Question 3

What is Heparin

Answer 3

Anti-Coagulant prevents the formation of fibrin.
There are 2 forms of Heparin.

1. Unfractionated Heparin Infusion (UHF)- used when LMWH is not appropriate such as if patient is at high risk of bleeding(as UHF infusion can be switched off instantly(half life is 2hrs), patient has renal impairment, massive PE’s, bridging therapy for high risk patients normally on warfarin requiring surgery.

2. Low Molecular Weight Heparin (LMWH):
Generic Name- (Brand Name)
Dalteparin (fragmin)
Enoxparin (lovenox)
Tinzaparin (Innohep)

Question 4

DOES LMWH NEED CHECKED

Answer 4

Bloods do not need checked with LMWH

Question 5

DOES UFH NEED CHECKED

Answer 5

Must check APTT ratio 4-6 hrs after starting infusion and 4-6 hrs after any dose adjustments.
Remind doctors as it is their responsibility to dose and re-prescribe.
APTT must be checked at least once every 24hrs if dose has not been changed.

Question 6

What is target range for APTT

Answer 6

1.5- 2.5

Question 7

What is APTT ratio

Answer 7

Clotting screen

Question 8

UFH

Answer 8

Should always have printed off protocol at patients bedside.

Question 9

UFH dose age is based on what

Answer 9

Patients weight and after initial dose APTT ratio