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nsg pharm 17
anticoagulants
| Question | Answer |
|---|---|
| HEPARIN | PTT should be 1.5-2.5 times control w/o s/s hemorrhage, lower limit of norm 20-25sec, upper limit of norm 32-39sec, antidote is PROTAMINE SULFATE w/in 30min -- heparin can be allergenic, NEVER give IM - if iv use pump, onset 20-60min & duration 8-12hr |
| LOVENOX | less allergenic than heparin, does not require lab test monitoring |
| Warfarin (COUMADIN) | normal pt 9.5-12sec, normal INR 2.0-3.5, o:12-24hr p:1.5-3days d:3-5days, antidote VITAMIN K/whole blood/plasma, avoid foods high in vit k(green veg,pork,rice,yogurt,fish,cheese,milk) |
| se | hemorrhage & fever |
| considerations | monitor hemorrhage, CBC, avoid IM inj/ASA/NSAIDS |
| herbal interactions | garlic/ginger/gingko incr bleeding c coumadin, ginseng/alfafa decr action, black haw incr action, chamomile may interfere |
| vitamin interactions | vit c decr coumadin effects, vit e incr coumadin effects |