BLOOD FORMING DRUGS/ ANTICOAGULANTS:

Prototype: Class: Clinical Use:

Prevent:

M.O.A.
Disrupts coagulation cascade Thins blood & stops more clots from forming DOES NOT DISSOLVE CLOT. Blocks conversion of prothrombin to thrombin & fibrinogen to fibrin

Adverse Effects:
Bleeding Diarrhea*, Dermatitis*, Alopecia* **ONLY common to Coumadin** Injection site reaction** Temp low platelet Thrombocytopenia Spontaneous bleeding May suppress renal function

Nursing Implications:
PO only! No Pregnancy Antidote: vitamin K Monitor PT & INR (Daily til stable dose reached) Avoid foods with Vit. K Monitor: PTT, Give subQ or IV, NEVER IM!! Antidote: protamine sulfate OK to Use w/ Coumadin & Asprin Never give w/ lovenox, penicillin, or cephalosporins No post op patients** Sub Q ONLY! NO LABS** Antidote: Protamine Sulfate (Rarely needed) NEVER GIVE WITH HEPARIN!!! Contraindicated in pts: w/ Peptic Ulcer disease & Post op pts have bleeding tendency. Monitor labs: CBC, PTT Need CAT scan before giving streptokinase b/c if you have clot in brain it will kill you so its RARELY USED***

Warfarin (Coumadin)

Anticoagulant (Oral)

DVT, MI, CVA, TIA, PE, Atrial Fib

Prevention & treatment:

Heparin

Anticoagulant (Parenteral)

CVA, MI, DVT, CAD, TIAs, CHF

Enoxaprin (Lovenox)
Asprin
&

low molecular weight heparin (LMWH) Antiplatelet drug

Knee and hip surgery Prevent DVT (For Maintenance & Prevention) Aspirin- prevention of MI Plavix- higher risk pt. Usually already had MI. Acute MI, stroke or limb threatening clot disorder, IV catheter or Shunts

Prevents conversion of factor Xa to Thrombin Does NOT dissolve the clot Inhibits Platelet aggregation

Thrombocytopenia Bleeding tendencies (Less bleeding tendency than Heparin) Bleeding tendencies** Angioedema, bronchospasms, Thrombocytopenia **BLEEDING (Very strong) Contraindicated for pts with bleeding disorders or if hemorrhagic

clopidogrel (Plavix)

Streptokinase (Streptase)

Thrombolytic Agent

DISSOLVES CLOTS!!!! Used ONLY in EMERGENCY!!! Enzyme from strep bacteria