Anticoagulant Agents

Question 1

What is the action?

Answer 1

Interfere with the normal cascade of events involved in the clotting process

Question 2

Anticoagulant agents drug names?

Hint: end with “arin” and “xaban”

Answer 2

Heparin
Warfarin
Rivaroxaban
Apixaban
Dabigatran

Question 3

Anticoagulant contraindications

Answer 3

Allergy
condition that could be compromised by ↑ bleeding tendencies
pregnancy
renal/hepatic disorders

Question 4

Anticoagulant agents drug-drug interactions (DDI)

Answer 4

Heparin: oral anticoagulants, salicylates, penicillins, or cephalosporins (↑ bleeding time)
Heparin: Nitroglycerin (↓ bleeding; ↑ risk of clotting)
Warfarin: Number of documented interactions

Question 5

Anticoagulant agents cautions

Answer 5

CHF (Ejection fraction is low)
Thyrotoxicosis (severe hyperthyroidism)
Senility
Psychosis

Question 6

Anticoagulant agents adverse effects

Answer 6

Bleeding
GI upset
Skin: alopecia (hair loss)
dermatitis

Question 7

Anticoagulant agents nursing implications

Answer 7

Look at history for contraindications/cautions
Active internal bleeding
Aneurysm
liver disease
Allergy, pregnant, lactation
look at skin for any bruising
peripheral pulses
VS & EKG
Lab: renal/hepatic fxn; clotting studies, CBC guaiac test for occult blood in stool
Effects of warfarin PT of 1.5-2.5 x the control value or INR 2-3
Heparin aPTI of 1.5-3 x the control value
Antidote on standby
Warfarin → vit k
heparin → protamine sulfate
Response to drug

Question 8

Anticoagulant agent prototype

Answer 8

Heparin

Question 9

Prototype Heparin Action

Answer 9

inhibits thrombus and clot production by blocking the conversion of prothrombin to thrombin & fibrinogen to fibrin

Question 10

Heparin adverse effects

Answer 10

Risk for bleeding
los of hair
bruising
chills, fever
osteoporosis
suppression of renal fxn (long-term use)
Lepirudin: a drug developed for the treatment of rare allergic reaction to heparin
Allergy to heparin → heparin induced thrombocytopenia HIT rapid decline in platelet count (can't have heparin again)

Question 11

Heparin indications

Answer 11

Prevention & Tx of venous thrombosis and PE (Clot in the lung)
Tx of AE with embolization
Dx & Tx of disseminated intravascular coagulation (DIC)
(pt bleeds & clots back & forth; don’t know when/which will happen)
Prevent clotting in blood samples & heparin lock sets (IV access)