Anticoagulation Agents

Question 1

Anticoagulation Agents Drug Names

Answer 1

Heparin
Warfarin

Rivaroxaban
Apixaban

Dabigatran

Antidote:

• Heparin: Vitamin K
• Warfarin: Protamine Sulfate

Question 2

Anticoagulation Agents Therapeutic Actions

Answer 2

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

Question 3

Anticoagulation Agents Indications

Answer 3

• Stop clotting

Question 4

Anticoagulation Agents Contraindications and Cautions

Answer 4

Contraindication:
•	Allergy 
•	Condition that could be compromised by increased bleeding tendencies
•	Pregnancy
•	Renal or hepatic disorder

Caution: 
•	CHF
•	Thyrotoxicosis
•	Senility 
•	Psychosis

Question 5

Anticoagulation Agents DDI

Answer 5

DDI:
• Heparin: oral anticoagulants, salicylates, penicillin’s, or cephalosporins
• Heparin: Nitroglycerin
• Warfarin: Number of documented interactions

Question 6

Anticoagulation Agents Adverse Effects

Answer 6

• Bleeding disorder
• GI upset
• Skin: Alopecia and dermatitis

Question 7

Anticoagulation Agents:

Assessments

Answer 7

Assess:
Hx: allergy, Pregnancy and lactation, active internal bleeding, recent surgery, CVA within the last 2 months, aneurysm, obstetrical delivery, organ biopsy, serious GI bleeding, major trauma, blood-clotting defects, cerebrovascular disease, uncontrolled hypertension, liver disease
Physical: vital signs, weight, heart & lung sounds, skin, perfusion(pulses), ECG (baseline)
Labs: Clotting studies, renal and hepatic, CBC, Guaiac test for blood in stool (PT & INR)

Question 8

Anticoagulation Agents:

Diagnosis

Answer 8

Dx:

• Risk for injury
• Disturbed body image
• Ineffective tissue perfusion
• Deficient knowledge

Question 9

Anticoagulation Agents:

Implementation

Answer 9

Implementation:
• Therapeutic range warfarin PT of 1.5-2.5x the control volume or INR 2-3
• Therapeutic range heparin- aPTT of 1.5-3x the control value
• Evaluate the patient for signs of blood loss
• Establish safety precautions/ measures
• Provide increased precautions against bleeding
• Mark charts of patient receiving this drug
• Monitor patient when any drug or herb is added with heparin
• Provide thorough patient teaching

Question 10

Anticoagulation Agents:

Evaluation

Answer 10

Eval:
Response to the drug
Adverse effects 
Effectiveness of comfort measures Compliance with the regimen
Effectiveness of the teaching plan