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26 Cards in this Set
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Anticoagulant medications |
Heparin Enoxaparin (lovenox) Warfarin (Coumadin) |
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Heparin Action: |
Prevents thrombin from converting fibrinogen to fibrin It doesn’t dissolve clots, but prevents new thrombus formation |
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If giving heparin I V |
Onset in 5 minutes and peaks in 2 to 6 hours, If given subcutaneous, onset in 20 to 60 minutes and lasts 8 to 12 hours Do not aspirate or rub the site and NEVER give intramuscular |
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What do you monitor with heparin |
APTT: activated partial thromboplastin, normal range is 20 to 40 seconds APTT should be 1.5 to 2.5 times the normal level |
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Antidote for heparin |
Protamine sulfate Used to reverse |
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Enoxaparin (lovenox) What is it |
Low-molecular weight heparin Less allergenic than heparin Using with heparin May result in injury or death |
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How do you give enoxaparin (lovenox) |
Subcutaneous never intramuscular or I V |
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Antidote for enoxaparin (Lovenox) |
Protamine sulfate Used to reverse |
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Warfarin (Coumadin) Action: |
Interferes with the liver synthesis of vitamin K Dependent clotting factors Prolongs clotting time |
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Warfarin (Coumadin) Given: |
Per oral Onset 12 to 24 hours and peaks at 1.5 to 3 days Often started prior to stopping heparin |
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Warfarin (Coumadin) Monitor: |
Prothrombin time and international normalized ratio Normal PT: 9 to 12 seconds, Therapeutic range is 1.5 to 2.0 times the control Normal I N R: 1.3 to 2.0 Therapeutic range is: 2.0 to 3.0 |
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Warfarin (Coumadin) Antidote: |
Vitamin K It is easy to get toxic to Coumadin |
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With all anticoagulants Side effects: |
Hemorrhage, monitor for Bruising, petechiae, nosebleeds, bleeding gums, blood in urine or stools, tarry stools, decreased hematocrit Can also use nausea, alopecia Urticaria |
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With all anticoagulants Teach patients: |
Avoid foods high in vitamin K Green leafy vegetables and certain meds like corticosteroids, NSAIDs and ASA containing products |
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With all anticoagulants Avoid giving: |
Intramuscular injection and venous stasis |
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What is important to maintain while using anticoagulants |
Regular lab tests |
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With all anticoagulants Herbal interactions: |
Anticoagulant action may be decreased if use chamomile, ginseng, alfalfa and anise |
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Thrombolytic Medications: |
Retaplase (retavase) Aletplase (activase) Streptokase |
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Thrombolytic Action: |
Activate plasminogen which generates plasmin which dissolves clots |
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Thrombolytic uses: |
Used early in course of M I, pulmonary embolism, thrombolytic strokes, and occluded shunts |
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Thrombolytic Side effects: |
Bleeding, dysthymias, allergic reaction Cannot use streptokase if patient has had strep within the past year |
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Thrombolytic Antidote: |
Amicar Used to reverse |
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Antiplatelet Medications: |
Plavix Persantine Ticlid Integrilin |
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Antiplatelet Action: |
Inhibit aggregation of platelets in clotting process |
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Antiplatelet Uses: |
Can be used with anticoagulants |
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Antiplatelet Side effects: |
Bleeding and flu like symptoms |