HNG 540 EXAM 4 STUDY GUIDE
1. Warfarin (Coumadin)- Answers - oral Anticoagulant
works by inhibiting vitamin K epoxide reducatse complex and prevents activation of vitamin K dependent clotting factors
(prothrombin 7,9,10)
takes 24-72 hours to work
and requires frequent INR (level
typically 2-3) has many dug and
dietary interactions
ok to use in renal impairment patients and is cost sensitive to
patients is contraindicated in pregnancy due to teratogenic
ettects
use carefully in patients with dementia, fall risk and uncontrolled HTN
2. What is the antidote for warfarin?- Answers - Vitamin K
3. What is warfarin used for?- Answers - afib
mechanical heart valves and DVT/PE propphylaxis and treatment
4. pt education for warfarin- Answers - maintain consistent intake of vit k foods such as spinach/kale- avoid
sudden changes in diet that may attect INR
regular INRR monitoring is required and watch for signs of bleeding and bruising
5. Lovenox/enoxaparin (low molecular weight heparin)- Answers - works by binding to
antithrombin III enhancing the inhibition of factor Xa and factor IIa (thrombin) leading to anticoagulation without
prolonging aPTT or TT at standard dosing
it has rapid onset after subq administration typically within 3-5 hours of peak activity
6. What is Lovenox used for?- Answers - prevention and treatment of DVT, PE and ischemic complications
of acute coronary syndrome (ACS)
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13
, preferred drug of choice for pregnancy because it does not cross the placenta
7. Apixaban (Eliquis)- Answers - a direct oral anticoagulant (DOACs)
works by selectively inhibits factor Xa both free and clot bound and inhibits prothrombin activity reducing thrombin generation
and clot formation
will need renal dose adjustments and people older then 80 as well as low body weight need dose adjustment has
a lower bleeding risk compared to warfarin
this is the preferred DOAC if covered by insurance due to safety and eflcacy
2/
13
1. Warfarin (Coumadin)- Answers - oral Anticoagulant
works by inhibiting vitamin K epoxide reducatse complex and prevents activation of vitamin K dependent clotting factors
(prothrombin 7,9,10)
takes 24-72 hours to work
and requires frequent INR (level
typically 2-3) has many dug and
dietary interactions
ok to use in renal impairment patients and is cost sensitive to
patients is contraindicated in pregnancy due to teratogenic
ettects
use carefully in patients with dementia, fall risk and uncontrolled HTN
2. What is the antidote for warfarin?- Answers - Vitamin K
3. What is warfarin used for?- Answers - afib
mechanical heart valves and DVT/PE propphylaxis and treatment
4. pt education for warfarin- Answers - maintain consistent intake of vit k foods such as spinach/kale- avoid
sudden changes in diet that may attect INR
regular INRR monitoring is required and watch for signs of bleeding and bruising
5. Lovenox/enoxaparin (low molecular weight heparin)- Answers - works by binding to
antithrombin III enhancing the inhibition of factor Xa and factor IIa (thrombin) leading to anticoagulation without
prolonging aPTT or TT at standard dosing
it has rapid onset after subq administration typically within 3-5 hours of peak activity
6. What is Lovenox used for?- Answers - prevention and treatment of DVT, PE and ischemic complications
of acute coronary syndrome (ACS)
1/
13
, preferred drug of choice for pregnancy because it does not cross the placenta
7. Apixaban (Eliquis)- Answers - a direct oral anticoagulant (DOACs)
works by selectively inhibits factor Xa both free and clot bound and inhibits prothrombin activity reducing thrombin generation
and clot formation
will need renal dose adjustments and people older then 80 as well as low body weight need dose adjustment has
a lower bleeding risk compared to warfarin
this is the preferred DOAC if covered by insurance due to safety and eflcacy
2/
13
