Module 2: Part 4 - IV Insulin and Heparin

Question 1

Anticoagulant therapy the primary method for managing what?

Answer 1

Acute deep vein thrombosis and PE.

Question 2

What effect does heparin have on emboli that are already in the blood?

Answer 2

None.

Question 3

For a heparin bolus, how many units are usually given?

Answer 3

5000

Question 4

It is difficult and time consuming to maintain and adjust the running heparin levels, what must be done to ensure accurate monitoring?

Answer 4

Frequent lab work

Question 5

What are 2 risks of longterm heparin use?

Answer 5

• Antibody formation

- Bleeding

Question 6

After initial clot formation and dislodgement it is necessary to start anticoagulant therapy. Why is this?

Answer 6

Because of the high risk for a recurrent thrombus.

Question 7

What is a therapeutic range of the international normalized ratio (INR)

Answer 7

typically 2.0 to 2.5.

Question 8

What are some alternatives for when heparin is contraindicated?

Answer 8

Lepirudin (Refludan) and argatroban

- These are direct thrombin inhibitors

Question 9

Lepirudin and argatroban are contraindicated in patients with:

Answer 9

• Overt major bleeding
• Hypersensitive
• High risk for bleeding
• Anomaly of vessels or organs
• Recent major surgery
• Recent puncture of large vessels, or organ biopsy

Question 10

How long after an embolic event must a patient continue to be on anticoagulants for?

Answer 10

3-6 months

Question 11

Can heparin be given as an intermittent IV?

Answer 11

Nope

Question 12

Can heparin be given as a continuous IV?

Answer 12

Yes

Question 13

Can heparin be given as a direct IV?

Answer 13

Yes

Question 14

How often should PTT be taken for patients on heparin?

Answer 14

Baseline PTT, then every 4 to 6 hours after initial bolus and each dose adjustment until stabilization, then once daily at the same time of day