hemologic and immune pharmothereaputics: vitamin k inhibitor

Question 1

vitamin k inhibitor MOA

Answer 1

• antagonizes vitamin K

- preventing the synthesis of four coagulation factors: VII, IX, X and prothrombin

Question 2

vitamin k inhibitor therapeutic uses

Answer 2

prevent DVT or PE, or clots for people who have a-fib or prosthetic heart valves, to reduce TIAS (stoke) or Mis

Question 3

vitamin k inhibitor antidote

Answer 3

vitamin K

Question 4

vitamin k inhibitor common med

Answer 4

warfarin (coumadin)

Question 5

vitamin k inhibitor complications

Answer 5

• hemorrhage
• hepatitis
• toxicity

Question 6

vitamin k inhibitor contraindications

Answer 6

• thrombocytopenia
• surgery- brain, eye, spinal cord, regional anesthesia
• vitamin K deficiencies, liver disorder, alcohol use disorder
• bleeding disorder

Question 7

vitamin k inhibitor interactions

Answer 7

• anticoagulants
• phenobarbital, carbamazepine, phenytoin, oral contraceptives, vit k decreases effect
• food high in vitamin k dark leafy green veggies, cabbage, canola/soybean oil
• resveratrol and saw palmetto, feverfew, garlic, ginger, glucosamine, and ginkgo biloa, increases risk of bleeding
• coenzyme q-10

Question 8

vitamin k inhibitor nursing implications

Answer 8

• oral admin same time each day (evening)
• obtain baseline vitals
• monitor PT, INR levels- if levels are higher than therapeutic, hold med and notify provider
• minior CBC- platelts and HCT levels (should stay WNL)
• be prepared to administer vitamin K as an antidote for warfarin toxicity
• pts will need frequent blood test for pt and ink levels if they are taking this at home
• bleeding precautions soft toothbrush, safety razor, monitor for s/s of internal bleeding

Question 9

vitamin k inhibitor pt teaching

Answer 9

• take in the evening, at the same time everyday
• avoid taking with alcohol or NSAIDS
• avoid food with high vitamin K content- dark leafy green (lettuce, cooked spinach) cabbage, broccoli, Brussels sprouts, mayo, canola, and soybean oils
• watch for bruising, bleeding gums, black tarry stools, coffee ground emesis
• use soft toothbrush safety razors
• you will need regular blood test to make sure you are on their right dosage of the medication

Question 10

meds prothrombin time (pt)-

Answer 10

normal 9.5 - 11.8 sec, therapeutic of warren 18-24 sec international normalized ration (NR) normal 0-1.1
therapeutic level 2-3

Question 11

platelets

Answer 11

normal 150,00-450,00 mm3

Question 12

WNL

Answer 12

within normal limit

Question 13

WDL

Answer 13

within defined limits

Question 14

hemocirt

Answer 14

normal 38-54%