Anticoagulants 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 (Streptase)

• gelatin (Gelfoam)