Anticoagulants (15) Flashcards
WARFARIN: Nursing Considerations
- Therapeutic PT @ 1.5–2.5 times the control, INR @ 2.0–3.0
- Onset: 12–24 hours, peak 1.5–3 days; duration 3–5 days
- Avoid foods high in vitamin K: many green leafy vegetables
- Do not interchange brands; potencies may not be equivalent
- Do not take any drug or herb without provider approval—may change effect
- Avoid ASA-containing products and NSAIDs
- Oral anticoagulants may cause red-orange discoloration of alkaline urine, interfering with some lab tests
- Wear medical information tag
- Antidote: vitamin K
- Rx; Preg Cat X
WARFARIN: Side Effects
- Hemorrhage
- Diarrhea
- Rash
- Fever
- Angina syndrome
- Anemia
- Dermatitis
- Jaundice
- Elevated liver enzymes
- Anaphylactic reactions
WARFARIN: Purpose
Prevention and treatment of deep vein thrombosis and pulmonary embolism, treatment of atrial fibrillation
RIVAROXABAN: Nursing Considerations
Dose reduction required in renal impairment
PO: give doses greater than 15 mg with food; lower doses may be given without regard to food
Stop med 24 hours before surgery
Monitor closely for signs of bleeding or excessive bruising
Rx; Preg Cat C
RIVAROXABAN: Side Effects
- Bleeding
- Bruising
- Pruritus
- Syncope
- Nausea
- Hematoma
- Elevated bilirubin
- Elevated ALT/AST
RIVAROXABAN: Purpose
Treatment and prevention of deep vein thrombosis and pulmonary embolism, prevention of stroke in patients with nonvalvular atrial fibrillation
HEPARIN: Nursing Considerations
- Therapeutic PTT @ 1.5–2.5 times the control without signs of hemorrhage
- IV: peak 5 minutes, duration 2–6 hours (give over 1 minute)
- Injection: give deep subQ; never IM (danger of hematoma), onset 20–60 minutes, duration 8–12 hours
- Antidote: protamine sulfate within 30 minutes
- Assess for signs of hemorrhage
- Avoid ASA-containing products and NSAIDs
- Wear medical information tag
- Abrupt withdrawal may precipitate increased coagulability
- Rx; Preg Cat C
HEPARIN: Side Effects
- Spontaneous bleeding
- Tissue irritation/pain at injection site
- Increased AST/ALT
- Anemia
- Thrombocytopenia
- Fever
- Rash
HEPARIN: Purpose
Prevention and treatment of deep vein thrombosis and pulmonary embolism
ENOXAPARIN: Nursing Considerations
- Injection: subQ; can be given IV during cardiac procedures
- Do not use in patients with a history of heparin-induced thrombocytopenia
- Use with caution in patients with impaired renal function or morbid obesity
- Monitor closely for signs of bleeding or excessive bruising
- Stop med 12–24 hours before surgery
- Rx; Preg Cat B
ENOXAPARIN: Side Effects
- Bleeding
- Bruising
- Injection site hematoma
- Injection site ecchymosis
- Increase in AST/ALT
ENOXAPARIN: Purpose
Prevention and treatment of deep vein thrombosis
DABIGATRAN: Nursing Considerations
- PO: may take without regard to meals
- Do not crush or chew capsules
- Closely monitor for signs of bleeding
- Increased risk of bleeding when combined with aspirin, other antiplatelets, or anticoagulants
- Stop med 24 hours before surgery
- Rx; Preg Cat C
DABIGATRAN: Side Effects
- Dyspepsia
- Abdominal discomfort
- Epigastric pain
- GI hemorrhage
- Bleeding
DABIGATRAN: Purpose
Prevention of stroke in patients with nonvalvular atrial fibrillation
