Pharmacology-Cardiovascular-Warfarin

Front 1

A brand of warfarin is?

Back 1

Coumadin

Front 2

The therapeutic classification of warfarin is?

Back 2

anticoagulant

Front 3

The pharmacologic classification of warfarin is?

Back 3

coumarins

Front 4

Warfarin is what kind of agent?

Back 4

coagulation modifier agent

Front 5

Indications for warfarin are?

Back 5

prophylaxis and treatment of:
venous thrombosis
pulmonary embolism
atrial fibrillation with
embolization
managment of myocardial
infarction
decreases risk of death
decreases risk of subsequent
MI
decreases risk of future
thromboembolic events
prevention of thrombus
formation and embolization
after prosthetic valve
replacement

Front 6

MOA of warfarin?
interferes withh hepatic synthesis of which vitamin-dependent clotting factors?

Back 6

vitamin K-dependent clotting factors II, VII, IX, X

Front 7

Therapeutic effects of warfarin include?

Back 7

prevention of thromboembolic events

Front 8

Assess patient for signs of which two problems?

Back 8

bleeding
hemorrhage

Front 9

Assess patient for what mouth condition?

Back 9

bleeding gums

Front 10

Assess patient's face for?

Back 10

nosebleed

Front 11

Assess integumentary for?

Back 11

excessive bruising

Front 12

Assess bowel movement for?

Back 12

black, tarry stools
guaiac-positive stools

Front 13

Assess blood for?

Back 13

hematuria
fall in hematocrit
fall in blood pressure

Front 14

Assess urine for?

Back 14

guaiac-positive urine

Front 15

Assess nasogastric tube for?

Back 15

nasogastric aspirate

Front 16

What are therapeutic ranges for PT and other clotting factors which should be monitored for frequently during therapy?

a standardized system that provides a common basis for communicating and interpreting PT results

Back 16

1.3 to 1.5 times greater than control

may also be reported as INR...what is INR?

Front 17

Define INR?
international normalized ratio

2-3 times the control value...PT of 1.5-2 or INR of 3-4.5 may be used for patients with high risk of embolization

Back 17

a standardized system that provides a common basis for communicating and interpreting PT results...PT values of 1.3-1.5 times the control are equivalent to INR values of?

Front 18

What liver and blood test should be monitored before and periodically throughout therapy?

Back 18

hepatic function
CBC

Front 19

What should be monitored for occult blood before and periodically throughout therapy?

Back 19

stool
urine

Front 20

Withholding 1 or more doses of medication is usually sufficient if PT is? (2)

Back 20

excessively prolonged or if minor bleeding occurs

Front 21

If overdose occurs or anticoagulation needs to be immediately reversed, the antidote is?

Back 21

vitamin K (phytonadione,
AquaMEPHYTON)

Front 22

Administration of whole blood or plasma also may be required in severe bleeding because of the delayed onset of?

Back 22

vitamin K

Front 23

Medication errors involving anticoagulants have resulted in serious harm and death from?

INR
PT...and have second physician independently check original order

Back 23

internal or intracranial bleeding...before administering, evaluate which recent labs?

Front 24

Because of the large number of medications capable of significantly altering warfarin's effects, careful monitoring is recommended when ______ _______ are started or other agents are discontinued.

Back 24

new agents

Front 25

What time of day should warfarin by administered?

Back 25

same time each day

Front 26

PO warfarin requires how many days to reach effective levels and is usually begun while patient is still on which med?

Back 26

3-5 days
heparin

Front 27

Do not interchange brands because?

Back 27

potencies may not be equivalent

Front 28

Direct IV: Reconstitute with 2.7 ml of _____ water
for injection.
Don't use solutions that are?

4 hrs

Back 28

sterile

discolored or contain particulate matter...reconstituted solution is stable for how many hours at room temp?

Front 29

Instruct patient to take med exactly as directed. If a dose is missed, tell patient?

at time of checkup or lab tests

Back 29

to take it as soon as remembered that day, but don't double dose...hcp should be informed of missed doses when?

Front 30

Review foods high in vitamin

antidote

alternating intake of these foods will cause which level to fluctuate?

Back 30

K...patient should have consistent limited intake of these foods, as vitamin K is the what for warfarin?

PT

Front 31

Caution patient to avoid which injections?

Back 31

IM...and avoid activities leading to injury

Front 32

Instruct patient to use what kind of toothbrush?

Back 32

soft...don't floss...shave with electric razor during warfarin therapy

Front 33

Advise patient that venipunctures and injection sites require application of?

bleeding
hematoma formation

Back 33

pressure to prevent what?

Front 34

Advise patient to report any symptoms of unusual?

Back 34

bleeding or bruising

Front 35

What should be noted as abnormal in the mouth?

Back 35

bleeding gums

notify dr

Front 36

What should be noted as abnormal on the face?

Back 36

nosebleed

notify dr

Front 37

What should be noted as abnormal in stools?

Back 37

black and tarry stools

notify dr

Front 38

What would be considered abnormal in the blood?

Back 38

hematuria

notify dr

Front 39

What would be noted concerning menstrual flow?

Back 39

excessive flow

notify dr

Front 40

What should the patient NOT ingest while taking warfarin?

Back 40

alcohol
OTC meds, esp NSAIDs or
aspirin-containing
don't start or stop any
new meds without dr's
advice

Front 41

What should be frequently monitored as far as lab tests?

Back 41

coagulation factors

Front 42

Instruct patient to carry ID with what?

Back 42

description of medication regimen...carry at all times and inform hcp caring for patient on anticoagulant therapy before lab tests, treatment or surgery

Front 43

Clinical response to therapy can be evaluated by?

Back 43

Prolonged PT (1.3 -2.0
times the control; may
vary)
OR
INR of 2-4.5 without signs
of hemorrhage