Anticoagulants
Published on Nov 23, 2015
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PRESENTATION OUTLINE
ANTICOAGS PREVENT:
- DVT,
- Pulmonary embolism,
- Myocardial infarction &
- Ischemic stroke
Photo by Pink Sherbet Photography
INDICATIONS
- Atrial fibrillation
- Pulmonary embolism
- DVT
- Venous thromboembolism
- Congestive heart failure
Arrhythmias assoc. higher level of blood clot formation due to stagnant or pooling blood = @ higher risk of stroke
Congestive heart failure = hypercoagulable state due to stagnant blood flow occurring as a result of left ventricular dysfunction. Higher risk of stroke
Congestive heart failure = hypercoagulable state due to stagnant blood flow occurring as a result of left ventricular dysfunction. Higher risk of stroke
Photo by Pulmonary Pathology
WARFARIN
(Coumadin & Marevan)
Often referred to as a 'blood thinner' —this is incorrect.
Warfarin actually works by increasing the time it takes for blood to clot.
INDICATIONS CONTINUED
- ...stroke
- Myocardial infarction
- Genetic or acquired hypercoagulability
- Thromboemboletic events related to surgery
Stroke -large artery atherosclerotic infarction, cardiac embolism, dissection, hypercoagulable states, hemorrhage, sickle cell disease.
Primary prevention the anti coagulation is key for improving pt outcome incidence, recurrence of stroke
MI: reduce mortality, recurrence, stroke or embolism
Surgical: cardiac valve replacement for the prevention and treatment VTE
Primary prevention the anti coagulation is key for improving pt outcome incidence, recurrence of stroke
MI: reduce mortality, recurrence, stroke or embolism
Surgical: cardiac valve replacement for the prevention and treatment VTE
Photo by Pulmonary Pathology
WARFARIN
(Coumadin & Marevan)
Action: Suppresses Vit. K dependent synthesis of prothrombin & factors VII, IX & X in the liver preventing the extension of established clot or formation of new clots.
Use: ~ Prevention & management of DVT or PE, prevention of thromboembolism in AF, or as an adjunct therapy for coronary occlusion.
Dose: Variable. Guided by a blood test called 'International Normalised Ratio' (INR). INR tests measure how fast the blood clots and allows the clinician to titrate a warfarin dose.
WARFARIN
(Coumadin & Marevan)
Nursing Considerations:
Adverse effects:
Bleeding, n & v, diarrhoea, multiple food and drug interactions...
Some antibiotics
ciprofloxacin (e.g. Ciproxin), erythromycin (e.g. Eryc), metronidazole (e.g. Flagyl), sulfamethoxazole with trimethoprim (e.g. Bactrim)
Anti-inflammatory and pain reliever medicines, including those used to treat arthritis
aspirin (e.g. Solprin), meloxicam (e.g. Mobic), celecoxib (e.g. Celebrex), ibuprofen (e.g. Nurofen), indomethacin (e.g. Indocid), methyl salicylate (e.g. Deep Heat Cream), paracetamol (e.g. Panadol) – when used more often than usual
Some heart and cholesterol medicines
aspirin (e.g. Cartia), clopidogrel (e.g. Plavix), amiodarone (e.g. Cordarone), simvastatin (e.g. Zocor), fenofibrate (e.g. Lipidil)
Some ulcer and reflux medicines
esomeprazole (e.g. Nexium), cimetidine (e.g. Tagamet), omeprazole (e.g. Losec)
Some antidepressants
fluoxetine (e.g. Prozac), fluvoxamine (e.g. Luvox), paroxetine (e.g. Aropax)
Corticosteroids
prednisolone (e.g. Solone)
Thyroid hormones
thyroxine (e.g. Oroxine)
Some anti-epileptic medicines
Carbamazepine (e.g. Tegretol)
Many cold and flu medicines
Some products contain medicines (e.g. paracetamol) which may interfere with warfarin
Some antifungals
Miconazole (e.g. Daktarin), fluconazole (e.g. Diflucan), griseofulvin (e.g. Grisovin)
Some vitamins, herbs and other complementary medicines
Such as vitamin K, vitamin E, fish oil, glucosamine, feverfew, garlic, ginkgo biloba, St John’s wort
ciprofloxacin (e.g. Ciproxin), erythromycin (e.g. Eryc), metronidazole (e.g. Flagyl), sulfamethoxazole with trimethoprim (e.g. Bactrim)
Anti-inflammatory and pain reliever medicines, including those used to treat arthritis
aspirin (e.g. Solprin), meloxicam (e.g. Mobic), celecoxib (e.g. Celebrex), ibuprofen (e.g. Nurofen), indomethacin (e.g. Indocid), methyl salicylate (e.g. Deep Heat Cream), paracetamol (e.g. Panadol) – when used more often than usual
Some heart and cholesterol medicines
aspirin (e.g. Cartia), clopidogrel (e.g. Plavix), amiodarone (e.g. Cordarone), simvastatin (e.g. Zocor), fenofibrate (e.g. Lipidil)
Some ulcer and reflux medicines
esomeprazole (e.g. Nexium), cimetidine (e.g. Tagamet), omeprazole (e.g. Losec)
Some antidepressants
fluoxetine (e.g. Prozac), fluvoxamine (e.g. Luvox), paroxetine (e.g. Aropax)
Corticosteroids
prednisolone (e.g. Solone)
Thyroid hormones
thyroxine (e.g. Oroxine)
Some anti-epileptic medicines
Carbamazepine (e.g. Tegretol)
Many cold and flu medicines
Some products contain medicines (e.g. paracetamol) which may interfere with warfarin
Some antifungals
Miconazole (e.g. Daktarin), fluconazole (e.g. Diflucan), griseofulvin (e.g. Grisovin)
Some vitamins, herbs and other complementary medicines
Such as vitamin K, vitamin E, fish oil, glucosamine, feverfew, garlic, ginkgo biloba, St John’s wort
