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6 Cards in this Set
- Front
- Back
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Heparin sodium (Hepalean, Hep-Lock) |
Indications: Administered parenterally (SQ or IV) as am antagonist to thrombin and to prevent the conversion of fibrinogen to fibrin
Adverse reaction: hemorrhage, agranulocytosis, leukopenia, hepatitis, heparin-induced thrombocytopenia
Nursing implication: - assess PTT, Hgb, Hct, platelets - assess stools for occult blood - avoid IM injection - notify anyone performing diagnostic testing of medication - Antagonist: protamine sulfate |
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Warfarin sodium (Coumadin, Coumnarin, Panwarfin) |
Indications: blocks the formation of prothrombin from vitamin K
adverse reaction: hemorrhage, agranulocytosis, leukopenia, hepatitis
Nursing implication: see heparin - give orally and assese PT - avoid sudden change in intake of foods high in vitamin K - antagonist: vitamin k |
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Antiplatelet Agents: - Ticlopidine (Ticlid) - Dipyridamole (Persantine) - Clopidogrel (Plavix) - Prasugrel (Efficent) - Ticagrelor (Brilinta) |
Indication: - short term use after cardiac interventiond - reduce risk for thrombolytic sroke for those intolerant to aspirin - prevention of thrombolytic disorder
Adverse reaction: neutropenia, thrombocytopenia, agranulocytosis, leukopenia, hemorrhage, GI irritation, bleeding, pancytopenia
Nursing implication: - Give PC or with food to decrease gastric irritation (Ticlid) - Advise not to take antacids within 2 hours of taking ticlopidine - Monitor CBC every 2 week for 3 months, and thereafter if signs of infection develops - Monitor for signs of bleeding - Give 1 hour of AC (Persantine); (Plavix) no regard for meals |
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Low-Molecular - Weight Heparins - Enoxaparin (Lovenox) - Tinzaparin (Innohep) - Dalteparin (Fragmin) |
Indication: Prevention of thrombolytic formation (deep vein)
Adverse reaction: hemorrhage, GI irritation, bleeding, thrombocytopenia
Nursing Implication: monitor for sign of bleeding, give SQ, monitor CBC, use soft toothbrush, avoid cuts |
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Factor Xa Inhibitor - Fondaparinux |
Indication: Prevention of thrombolytic formation (deep vein)
Adverse reaction: hemorrhage, GI irritation, bleeding
Nursing Implication: monitor for sign of bleeding, give SQ, monitor CBC, use soft toothbrush, avoid cuts |
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Group IIa-IIb Inhibitor (Platelet Antiaggregant) - Eptifibatide (Integrilin) - Tirofiban (Aggrastat) - Abciximab (ReoPro) |
Indication: - acute coronary syndrome (unstable angina or non-Q wave MI) - used in combination with heparin, aspirin, and, in selected situation, Ticlid and Plavix
Adverse Reaction: - bleeding, most frequent - hypotension, thrombocytopenia - acute toxicity: decreased muscle tone, dyspnea, loss of righting reflex
Nursing implication: - check drug-drug interactions before giving other medications - obtain baseline PT/PTT, Hgb, Hct, and platelet count, and monitor - dose adjusted by weight for older adults - same client teaching as with heparin; review activities to avoid - watch for bleeding - quickly reversible, so emergency procedures may still be performed shortly after discontinuing infusion
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