Pharmocology

Question 1

All anticoagulants:

Answer 1

Monitor CBC and hold for thrombocytopenia.
Notify HCP for unusual bleeding
Client teaching:
Do not abruptly stop the medication.
Never double a missed dose.
Avoid NSAIDs (aspirin, ibuprofen).
Use an electric razor and soft-bristled toothbrush.
Avoid activities with risk for injury (contact sports,
construction work).

Question 2

Instruct clients taking warfarin

Answer 2

keep a consistent intake of vitamin K (spinach, kale) and to avoid
OTC medications, especially those containing St. John’s wort, aspirin or other NSAIDs, or “G” supplements
(garlic, ginseng, ginkgo).

Question 3

Direct oral
anticoagulants
(DOACs)
rivaroxaban
apixaban
dabigatran

Answer 3

Administration:
Unlike warfarin, DOACs work quickly and do
not require INR monitoring.

Question 4

Vitamin K
antagonist
warfarin

Answer 4

Cautions:
Takes 5-7 days to start working: Not for
emergency treatment of clots
Several drug interactions: Avoid all medications
and supplements not prescribed by the HCP
(“SAG” medications).
Administration:
Monitor INR.
Antidote: Vitamin K
Keep a consistent intake of leafy green
vegetables.

Question 5

Heparins
heparin
enoxaparin

Answer 5

Cautions:
Risk for HIT: If client develops thrombocytopenia,
stop the heparin and notify the HCP.
Administration:
Monitor PTT when giving IV heparin.
Antidote: Protamine
Never give IM.
Do not rub the injection site or eject the air
bubble from a prefilled syringe.