1 / 34

Anticoagulants

Anticoagulants. NURS 1950 Pharmacology I. Objective 1: identify general reasons anticoagulants are given. Objective 2: identify the cells in the body that release heparin Objective 3: describe the actions of heparin. Objective 4: list the appropriate routes to administer heparin.

norah
Télécharger la présentation

Anticoagulants

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Anticoagulants NURS 1950 Pharmacology I

  2. Objective 1: identify general reasons anticoagulants are given

  3. Objective 2: identify the cells in the body that release heparin • Objective 3: describe the actions of heparin

  4. Objective 4: list the appropriate routes to administer heparin

  5. Heparin: only parenteral administration • Warfarin: oral • Heparin • Low doses: inhibit clotting factor Xa • High doses: inhibits all clotting factors • Effects occur immediately

  6. Preferred during pregnancy, PE, DVT • Required for open heart surgery, renal dialysis

  7. Side Effects • Hemorrhage: observe hypotension, tachycardia, petechiae, bruises • May see bloody stools, pelvic pain, headache • Hypersensitivity: chills, fever, rash • Antidote: protamine sulfate

  8. Administration • IV or subq • IM causes hematoma • Monitor PTT above 1.5-2 X normal is therapeutic • Monitor INR: between 2-3

  9. Enoxaparin (Lovenox): low molecular weight • Acts so has less potential for hemorrhage, longer duration of action • Subq administration • Does not affect PT or APTT • Do not give to clients allergic to pork by-products

  10. Do not inject IM • Do not expel air bubble from syringe before injection • Do not rub injection site

  11. SE to expect: hematoma with improper injection technique • SE to report: bleeding, thrombocytopenia • Drug interactions: no clinically significant interactions • Caution: antiplatelet or warfarin therapy

  12. Warfarin (Coumarin) • 1st oral • Antidote: Vitamin K • Monitor protime • Needs to be 1.5 to 2X normal • Monitor INR: 2-3

  13. Interactions • Heparin • ASA • Butazoladin • Barbiturates

  14. Dicumerol: derived from Coumarin • Erratic absorption • Prevents thrombi in veins

  15. Objective 5: identify the antidote for heparin

  16. Objective 6: name the lab tests that are the basis to determine the effectiveness and dosage of heparin

  17. Objective 7: describe the important points regarding subcutaneous administration of heparin • Dose/strength • Injection site • Needle/syringe • Aspiration • Pressure

  18. Objective 8: list the signs of heparin overdose • Bleeding • VS changes • Thrombocytopenia • White clot formation is a toxic reaction

  19. Objective 9: identify drugs that enhance the action of heparin • NSAIDs • ASA • Ginkgo biloba • Dipyridamole • Clopidogrel • Ticlopidine

  20. Objective 10: describe the action of Coumadin • Inhibits the activity of vitamin K—needed for activation of clotting factors II, VII, IX and X

  21. Objective 11: name the lab tests done to determine the effectiveness and dosage of Coumadin

  22. Objective 12: identify drugs that increase and decrease the effectiveness of Coumadin • Drugs that can increase Coumadin effects: Tylenol, ASA, dong quai, ginkgo biloba, oil of wintergreen, omeprazole • Drugs that can decrease the effects: St. John’s Wort, rose hip, barbiturates, griseofulvin, vitamin C, vitamin K

  23. Objective 13: discuss other select anticoagulant agents • Fibrinolytic agents • Antiplatelet drugs

  24. Antiplatelet Drugs • Suppress aggregation platelets • Prevent arterial thrombus • ASA single dose; 5 gr or less • Doubles bleeding time for 4-7 days • Reduces MI, TIAs, CVAs

  25. Persantine • Enhances effect of ASA • No significant effect used alone • With warfarin: clients with prosthetic heart valves

  26. Thrombolytic Drugs • Streptokinase • Promotes plasminogen to plasmin • Uses • Acute coronary thrombi • DVT • Massive pulmonary emboli

  27. MI: must give within 6 hours • DVT: give within 3 days • PE: no more than 5-7 days

  28. Side Effects • Hemorrhage: use Amicar • Fever, allergic reaction Drug given IV

  29. Urokinase • Promotes plasminogen to plasmin

  30. TPA: tissue type plasminogen activator • Synthetic • Clears coronary artery • SE: bleeding

  31. Objective 14: discuss the indications for antiplatelet drugs • Previous MI, CVA, TIA • Conditions that predispose to clot formation • Some used in combination post cardiac valve replacement • Peripheral arterial disease • Atrial fibrillation • Unstable angina

  32. Objective 15: describe the nursing responsibilities associated with a client receiving an anticoagulant, including specific safety considerations

  33. Dosage schedules • Hydration • Lab data • Preventing clot formation • Patient teaching • Follow-up • Safety

  34. Medic alert bracelet • Symptoms to report • Do not take OTC meds without consulting MD

More Related