1. Anticoagulations and Coagulants
NUR 312
Brenda B. Rowe

2. Anticoagulants
Prevent thrombus formation and the extension of existing thrombus
Heparin: onset 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 x control

3. enoxaparin (Lovenox Considered safer and equally effective as heparin
used for prophylaxis
given subcutaneous
patient teaching

4. 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

5. Coumadin (cont.)
PT (prothrombin time) or INR (international normalized ratio) monitor therapeutic results with these lab tests (I.e. PT x control, INR should be 2-3)
Antidote is vitamin K

6. 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

7. aspirin
Antiplatelet
Prophylaxis – MI & TIA

8. 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

9. 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

10. Topical hemostatic agents
oxidized cellulose (Surgicel)
gelatin (Gelfoam)