anticoagulants Flashcards
what do anticoagulants do?
prevent blood clotting. It withholds coagulation factors
why are anticoagulants given? key word?
prevention of new clots and preventing existing clots. specifically with patients recovering from an mi heart attack or those at risk for a DVT like after a hip or knee surgery
what dissolves clots?
thrombolytics like TPA and alteplase
do anticoagulants dissolve clots?
no only thrombolytics do this
what do anticoagulants block?
fibrin
anticoagulation withholding clotting factors in the coagulation cascade mainly blocking the formation of fibrin since fibrin forms the seals on the clock.
what is the difference between warfarin and heparin?
heparin works quickly and can only be injected like IV or SQ into the patient like enoxaparin or Lower weight molecular heparin.
warfarin works slowly it takes 5 days to start working. BUT IT LASTS LONGER AND CAN BE TAKEN LONGER.
What is the key word for heparin and warfarin being taken at the same time?
BOTH MEDICATIONS ARE GIVEN TOGETHER FOR SEVERAL DAYS
Anticoagulant labs:
IF THEY ARE TOO HIGH THE PATIENT WILL BLEED OUT AND DIE
BUT IF THEY ARE TOO LOW THE RISK FOR CLOTTING GROWS
Labs to know for heparin?
PTT: 46 TO 70
ANYTHING MORE THAN 70 Hold medication
what is the antidote for heparin?
PROTAMINE SULFATE
Heparin drip PTT 85 or 100?
PTT IS OVER 70 so the priority is?
1.) stop the heparin drip and notify HCP
- ) Prepare antidote protamine sulfate
- ) reassess labs in 1 hour
if their is a patient on a heparin drip with bleeding at the iv site or “BLOOD OOZING AT THE SURGICAL INCISION”?
- ) Stop the infusion and notify HCP
- ) ADMINISTER protamine sulfate
- ) reassess labs in 1 hour
labs for warfarin?
INR 2 to 3
heart valve replacements: 2.5 to 3.5
what is the antidote for warfarin? and where is it found?
vitamin k
seen in liver and green leafy vegetables like broccoli and spinach
when can vitamin K not be given?
when warfarin is in therapeutic range
at least 5 days on warfarin therapy when switching to IV heparin
what is patient teaching on vitamin k and warfarin?
consistency and moderation
DO NOT INCREASE
DO NOT DECREASE
DO NOT AVOID TOTALLY
NICE CONSISTENCY MODERATION
What does the statement I will increase my intake of dark green leafy vegetables mean?
requires intervention since it has to be a nice consistency in moderation
ANTIBIOTICS INCREASE THE RISK OF BLEEDING!!!
since it INCREASES the INR. SINCE ANTIBIOTICS KILLS THE intestinal bacteria that produces vitamin K that ends up with a vitamin K deficiency, which increases the risk for bleeding.
what do you do when you are on warfarin with an IINR of 4 or 5?
- ) assess for bleeding
2. ) get vitamin K antidote ready
what to do if your INR is 2.0 and your patient has ischemic CVA?
administer warfarin so that it increases to 2.5
Warfarin patient teaching?
- ) Taken LIFE LONG to prevent clots like in patients with:
- ) -atrial fibrillation
- artificial heart valve replacements typically more prevalent in key term -mechanical valve replacements.
3.) FREQUENT BLOOD TESTS to check the therapeutic range
what requires frequent blood tests?
WARFARIN ONLY
how long is heparin given for? and what is is usually given IV?
A few days or a few weeks
usually given after an mi heart attack or a Pulmonary embolism in the lung to prevent the clot from growing
What do heparin SQ end in? and what are they called?
parin like:
enoxaparin
Dalteparin
LESS CHANCE OF BLEEDING
LOWER WEIGHT MOLECULAR HEPARIN
