Anticoagulants and Coagulants

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Anticoagulants and Coagulants

• NUR 312
• Brenda B. Rowe

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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

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enoxaparin (Lovenox

• Considered safer and equally effective as heparin
• used for prophylaxis
• given subcutaneous
• patient teaching

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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

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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

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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

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aspirin

• Antiplatelet
• Prophylaxis MI TIA

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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

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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

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Topical hemostatic agents

• oxidized cellulose (Streptase)
• gelatin (Gelfoam)