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anticoagulant drugs
heparin, LMWH,
| Question | Answer |
|---|---|
| What are anticoagulants | drugs that prevent clots from forming to maintain or restore circulation |
| do anticoagulants dissolve existing clots | NO |
| What are the two types of anticoagulants | Parenteral & Oral |
| What is the prototype drug for parenteral anticoagulants | heparin |
| How is heparin administered | SubQ injection in the abdomen / sites rotated / Never Aspirate |
| When is heparin ( parenteral anticoagulant) given | only in the hospital |
| Why is heparin only given to patients in the hospital | it puts the patient at a high risk for bleeding, and requires frequent PTT monitoring |
| Before you can take a patient off of heparin what has to be done | they are started on coumadin(warfin) the oral anticoagulant |
| What are LMWH (low molecular weight heparins) | a form of heparin that provides equivalent action but has lower risk of bleeding, requires less frequent doses,and monitoring due to longer 1/2 life |
| What is the most common LMWH | enoxaprin (lovenox) |
| Other LMWH are | fragmin, normiflo, orgaran, innohep |
| Can a patient use LMWH at home | YES, b/c less risk of bleeding, pt.& family can be taught how to administer it. |
| How long are patients usually on heparin | short term 7-14days at 1-2 doses a day |
| What conditions require prompt heparin (anticoagulant)therapy | evolving ischemic stroke, pulmonary embolism, massive DVT, DIC |
| What is a ischemic stroke | the blood supply is cut off from the brain |
| what is the only anticoagulant given during pregnancy & why | heparin, it will not cross the placenta |
| What are some common prophylactic reasons for giving heparin | after hip/knee replacement, or abdominal surgery to prevent clots from forming |
| What is DIC | when several microemboli form the body uses all its clotting factors,& the blood thins, pt bleeds from any exit |
| How can heparin help DIC | it stops the body from clotting and reverses the problem which is the formation of several small clots |
| After a acute MI heparin | is given with thrombolytics to prevent clots from forming |
| What are the side effects of heparin | hemorrhage, dose related bone demineralization, thrombocytopenia, hypersensitivity reactions |
| What are the signs of hemorrhage | increased HR..decreased BP..brusing, petechiae, hematomas, black tarry stool |
| What should you do for a overdose of heparin (anticoagulant) | stop heparin, give protamine sulfate, avoid aspirin, monitor PTT (keep <2X base) |
| What is the antidote for heparin | protamine sulfate |
| What can dose related bone demineralization from use of heparin cause | osterprosis |
| If your patient is going to be taking heparin at home you must teach | S/S of bleeding, to use safety razors, electric razors, & soft toothbrushes |
| What are the Nursing Interventions for heparin | monitor PTT,CBC, platelet count, HCT,read label closely to avoid overdose, Always double check dose w/another nurse, use infusion pump for cont.IV. |
| When heparin is given via continuous IV how often should you monitor the rate | q30 - 60 min. |
| How often do you check PTT with heparin therapy | q4-6 hrs until dose is regulated, then daily |
| How do you give heparin SubQ | use 1/2 inc, 25-26 gauge needle, inject into the abdomen 2inc from umbilicus, DO NOT aspirate, & rotate sites |
| What OTC drug should never be taken with heparin (parenteral anticoagulant) | aspirin |
| It is important to check OTC drug labels when on heparin because | many contain aspirin (sylicia) |
| What herbs when taken with heparin increase the risk for bleeding | dong quai, fever few, garlic, ginger, ginko, black haw, chamomile, & bilberry |
| What herbs when taken with heparin decrease the effects of heparin | anise, ginseng, alfalfa, goldenseal, valerian |
| What is the normal PTT level | 60-80 seconds |
| What is the action of oral anticoagulants | inhibit synthesis of vitamin K, and affects clotting factors |
| Anticoagulants are primarily used for | venous thrombosis |
| How do you know if the patient has thrombocytopenia | platlet count will be < 100,000 |
| What should be done if a heparin patient has thrombocytopenia | anticoagulant therapy using non heparin agents should be used |
| what are examples of non heparin parentral anticoagulants | refludan & acova |
| What are the S/S of hypersensitivity to anticoagulants (heparin) | chills, fever, urticaria (hives) |
| What is urticaria | hives |
| what should be done to prevent hypersensitivity reactions | a small test does before giving heparin |
Created by:
leseanne
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