1050: heparin & warfarin (anticoagulants)
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heparin and warfarin are what class of drugs?
What are they more commonly called?
anticoagulants, more commonly known as "blood thinners".
What lab value is used for heparin and what should you check daily?
What is used for warfarin?
- heparin: aPTT (activated partial thromboplastin time)
- *check platelet count daily.
warfarin: INR (international normalized ratio)
What is the action of heparin?
inactivates factor X to prevent conversion of prothrombin to thrombin so a stable clot is not formed.
What is the use of heparin?
Takes the blood a longer time to clot; prevents formation of blood clots in veins, arteries, or lungs.
Normal clotting time: 25-35 seconds.
Therapeutic value: 45-70 seconds.
What are some contraindications for heparin?
(hint: think about its action; use)
- severe kidney or liver disease
- 3rd trimester of pregnancy
What are some side effects of heparin?
What should you monitor b/c of the side effects?
- anemia: monitor for bleeding
- bruising: check for bruises.
(remember bald and bruised man)
What are some adverse reactions to heparin?
What antidote is used for one of the adverse reactions?
- **HIT, if overdose: use antidote: protamine sulfate.
What drug interactions are involved with heparin?
- Smoking (decreases effects)
- aspirin, NSAIDs, clopidogrel (anti-platelet)
What are some nursing actions for heparin?
What would you give if Pt overdosed on heparin?
Give the antidote, protamine sulfate.
Monitor for bleeding
Check aPTT platelet count daily
Which drug would you use for a long-term anticoagulant?
Why is warfarin administered for a Pt leaving the hospital who was on heparin IV?
Pt on heparin (IV) are tapered off with the oral form of warfarin while reducing the use of heparin. The Pt takes continues to take warfarin afterwards.
What is the action of warfarin?
Interferes w/ the formation of vitamin K-dependent clotting factors.
What is warfarin used for?
Prevents and treats thrombosis.
*started after heparin therapy.
What is warfarin contraindicated for that is similar to heparin?
What are other contraindications?
- open wounds
- may cause fetal hemorrhage
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