Practical Approach to Coumadin Therapy Lecture Powerpoint Flashcards
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What are some conditions that might encourage use of anticoagulant therapy prophylactically? (4)
- Immobilized patients
- atrial fib
- orthopedic surgery
- genetic coagulation anomalies
Some examples of hypercoaguable states (4)
- post surgery
- thrombophilia
- dehydration
- estrogen therapy
Some examples of vascular damages (4)
- thrombophlebitis
- venepuncture
- strain
- atheroschlerosis
Some examples of circulatory stasis (4)
- immobility
- venous obstruction
- varicose veins
- atrial fib
Prothrombin is also known as….
….factor II
Warfarin (Coumadin and jantoven) is an ingredient in….
…rat poison
Vitamin K consumption must be watched and moderated (generally want to keep it constant) when on what drug therapy?
Warfarin (coumadin)
Contraindications to warfarin (coumadin and jantoven) (4)
- history of hemorrhagic stroke
- uncontrolled hypertension
- active bleeding
- MI due to aortic dissection
Warfarin is part of the ____ clotting cascade and is measured by ____. Heparin is part of the ___ cascade and is measured by ____
extrinsic, PT INR
Intrinsic, PTT
a prolonged PT but a normal PTT result indicates…
-Decreased vitamin K
Prolonged PT and PTT results indicate
Defective factor X, DIC
Dosing warfarin therapy
- Initiate therapy with estimated daily maintanance dose (2-5 mg daily) while maintaining current heparin management for 3-5 days or until therapeutic dosage reached
- check INR on days 3-5
- goal time is btwn 2-3, if less than 2 must increase dosage and if greater than 3 stop for that day and recheck next day (might take a few days to adjust)
- If 3-4.5 then decrease weekly dosage by 10% or 1mg/d for 3 days of next week and repeat PT in 1 week
- If 1.5-2 then increase weekly dose by 10% or 1mg/d for 3 days of next week and repeat PT in 1 week
Dabigatran (pradaxa) is a ____ that can be administered ___ and does not require ____
- direct thrombin inhibitor
- oral
- INR monitoring
