Anti-Coagulant Medication Flashcards
Anti-coagulant Medication
-Overview
- Prolongs bleeding by interfering w/ the clotting cascade
2. Given when pt has high risk of developing thrombosis (clot)
Anti-coagulant Medication
-Specific’s
- warfarin (coumadin)
- heparin
- enoxaparin (Lovenox)
Warfarin (Coumadin)
-Action
Interferes w/ the vitamin K dependent factors by reducing synthesis of vitamin K in the liver
- Takes 3-5 days reach therapeutic dose due to the fact that it needs to act on the factory
Can be given Orally
Heparin
-Action
Prevents conversion of:
- Prothrombin to thrombin
- fibrinogen to fibrin
Given SubQ.. Not given orally
Warfarin (Coumadin)
-Antidote
Vitamin K
Heparin
protamine sulfate
Coumadin
-(Therapeutic Range)
“PT” “INR”
- Measure PT for Coumadin
- Normal PT is 9 seconds
- 1.5 to 2X baseline = therapeutic range
INR therapeutic range is about 2-3
INR baseline is .9
Coumadin
Reaching therapeutic range
Use a loading dose to speed up the 3-5 days that it takes to reach therapeutic levels
Heparin
-Specific Points
- Quick onset
- Used in emergencies
- OK with pregnancy
- Can be given SUBQ or IV
- Short half-life
Heparin
-Measuring Therapeutic Range (PTT)
PTT baseline = 25
PTT therapeutic range for Heparin = 37.5 - 62.5
Enoxaparin (Lovenox)
-Specific Points
- Same as heparin except w/ longer half-life
- Only given SubQ
- Lower molecular weight, doesn’t bind w/ protein as much
- Same as heparin so PROTAMIEN SULFATE is ANTIDOTE
Coumadin
-Drug interactions
- Avoid Alcohol especially w/ coumadin
- Alcohol will prolong bleeding and throw off values. You could mistakenly reduce coumadin dose into untherapeutic range - Green Leafy vegetables
- vitamin k is high in leafy veggies so don’t overeat while on Coumadin
