Warfarin (coumadin)

Question 1

• Therapeutic Classification

Answer 1

Anticoagulant

Question 2

• Pharmacologic Classification

Answer 2

vit K antagonist

Question 3

Pregnancy Category

Answer 3

X

Question 4

• Mechanism of Action

Answer 4

o Inhibits two enzymes involve in formation of activated vitamin K
o Inhibits synthesis of new clotting factors (II, VII, X)
o Antidote Vitamin K

Question 5

• Indications:

Answer 5

o Prophylaxis arterial thromboembolism
o DVT
o Pulmonary Embolism
o Long-term indwelling catheters

Question 6

• Precautions

Answer 6

o	Dental Procedures
o	CHF (Congestive Heart Failure)

Question 7

• Contraindictions:

Answer 7

o	Recent Trauma
o	Active internal bleeding
o	Serious bleeding disorders
o	Intracranial hemorrhage
o	Severe HTN
o	Bacterial endocarditis
o	Severe hepatic/renal impairment
o	Pregnancy

Question 8

• Adverse Effects

Answer 8

o Microembolism
o Osteoporosis
o Bone fractures

Question 9

• Serious Adverse Effects

Answer 9

o Abnormal Bleeding

Question 10

• Nursing Responsibilities

Answer 10

o Complete health history
o Monitor PT/INR
o Monitor urine, stool, liver function and blood
o Monitor risk groups for nonadherence

Question 11

• Patient/Family Teaching

Answer 11

o	Minimize risk of injury
o	Report bleeding symptoms
o	Stop drug and immediately report signs of hepatitis
o	Use same brand and take at same time
o	Avoid high fat diet
o	Avoid excessive alcohol
o	Inform dentist
o	Extra precautions to avoid pregnancy