Anticoagulants Flashcards
Heparin*
Classification: Indirect Thrombin Inhibitor
How it works:
○ Thrombin → converts fibrinogen to fibrin → Fibrin forms clots!
○ Antithrombin III inhibits Thrombin
○ Heparin ENHANCES antithrombin III
○ This stops thrombin from being activated, = prevents clots from forming
● This is the intrinsic coagulation pathway = SLOWS DOWN CLOTTING
Ex: Chronic atrial fibrillation, strokes (neuro), myocardial infarction, post-op, PE
IV Med titration:
○ Patients on a heparin drip have aPTT lvls drawn q4-6 hours to titrate the drip
■ Normal aPTT: 30-40 seconds
■ Therapeutic aPTT: 1.5-2x normal
Biggest SE to monitor: BLEEDING!
- Hematuria, hematemesis, bruising, ↓ trending H&H
ANTIDOTE = protamine sulfate
Warfarin
Therapeutic class: Anticoagulant
Indication: venous thrombosis, pulmonary embolism, A-fib
Action: disrupts liver synthesis of Vitamin K dependent clotting factors
Nursing Considerations:
● Diet - avoid leafy greens
● Monitor for bleeding
● Monitor PT and INR
○ PT
■ Normal: 10-12 seconds
○ INR
■ Normal: 0.9-1.2
■ Therapeutic INR: 2-3
● ANTIDOTE: Vitamin K
● Contraindicated during pregnancy
Clopidogrel
Low-molecular weight heparin
