Anticoagulations and Coagulants NUR 312 Brenda B. Rowe

Anticoagulants Prevent thrombus formation and the extension of existing thrombus Heparin: onset 20-60 minutes, given via continuous infusion or subc., most common side effect is bleeding, antidote is protamine sulfate, want therapeutic lengthening of clotting time, monitor APTT - should be 1.5-2 x control

enoxaparin (Lovenox Considered safer and equally effective as heparin used for prophylaxis given subcutaneous patient teaching

Coumadin Oral anticoagulant anticoagulant. Effects do not begin for 24 hours with maximum effect in 3-4 days, pt. will receive coumadin before heparin is d/c increase change of bleeding with aspirin, NSAIDS, & chronic use of Tylenol Education: avoid diets high in Vitamin K, take at same time, check out OTC drugs

Coumadin (cont.) PT (prothrombin time) or INR (international normalized ratio) monitor therapeutic results with these lab tests (I.e. PT 1.4-1.6 x control, INR should be 2-3) Antidote is vitamin K

Ticlid Inhibits platelet aggregation used with patients who cannot tolerate aspirin most common side effect is diarrhea should not be administered with aspirin should be given with food monitor neutrophils & platelet count

aspirin Antiplatelet Prophylaxis – MI & TIA

streptokinase Breaks down formed clot most effective if initiated within 6 hours of onset of symptoms severe bleeding occurs frequently & fever occurs in 30% of patients

Clotting factors & hemostatics antihemophilic factor (AHF) - used to treat patients with deficiency of clotting factor VIII, hemophilia A human factor IX complex: tx hemophilia B aminocaporic acid: enhances blood coagulation/used to tx severe bleeding

Topical hemostatic agents oxidized cellulose (Surgicel) gelatin (Gelfoam)