Exam 3 (MIDTERM) Comprehensive
Questions (Frequently Tested) with
Verified Answers Graded A+
What are indications for anticoagulants? - Answer: MI, unstable angina, atrial fibrillation,
indwelling devices (mech heart valve) major orthopedic surgery or prolonged periods of
immobilization or long plane rides, strokes..
What are contraindications for anticoagulants? - Answer: Known drug allergy
thrombocytopenia
Pregnancy (Warfarin)
Indwelling epidural catheter (LMWH) d/t link with epidural hematoma
What are adverse rxns with Anticoagulants? - Answer: Most common: BLEEDING (localized or
systemic) for all anticoagulants!
Heparin induced thrombocytopenia (HIT)
nausea, vomiting, abdominal cramps, thrombocytopenia, bruises
Route and procedures for anticoagulation therapy - Answer: Oral and parenteral (Injection/IV)
Why is Heparin used for anticoagulation? - Answer: Preventative, heparin either unfractionated
or low molecular weight (subcutaneous -lovenox) Both can be used as preventative and DVT
treatment
It works faster than Warfarin/Coumadin.
Can be given subQ or IV
,What labwork is needed to monitor pts on Heparins - Answer: Heparin = activated PTT every 6
hrs or so, 2-3 days check a CBC d/p for platelet values.
LMWHeparins = none
What is special about the low molecular weight Heparin - Answer: They are more predictable
because they are specific for activated factor Xa. Greater bioavailability longer elimination half
life than unfractionated.
What are the reversal drugs for warfarin and Heparin? - Answer: Warfarin = Vit K
Heparin = Protamine sulfate
Heparin (pg 631 in drug guide) - Answer: Given parenteral
Preg category C
Short half life (1-2 hours)
Low molecular weights: Preg category B
Lovenox: Don't give inj near umbilicus
don't require labwork
DONT rub injection sites - could cause bruising
Heparin adverse effects - Answer: Bleeding
hematoma
anemia
thrombocytopenia (HIT)
Drug induced hepatitis (inflammation)
alopecia
osteoporosis
fever
, hypersensitivity
Know about how Coumadin (Warfarin) works for anticoagulation - Answer: Inhibits Vit K
dependent clotting factors II, VII, IX, and X. Used for clot prevention. Given PO
Important teaching for Heparin - Answer: Regular lab testing
Sx of abnormal bleeding
Wear a medical alert bracelet
Use soft toothbrushes to prevent gum bleeding. watch for nose bleeds, bloody dark stools, can
make nauseous
Monitoring lab work for Coumadin? - Answer: Coumadin, PT / INR
PT typically 11-13 seconds, therapeutic is 18 seconds
pts not on anticoagulants typically have INR value of 2-3
pts on warfarin/Coumadin value is 2 to 3.5 with a target of 3
What are the Therapeutic Levels, INR, aPTT, PT? - Answer:
Coumadin (pg 1273 in drug guide) - Answer: Given orally only
Preg category X
Monitored by PT INR
Genetic factors alter metabolism of drug
Coumadin adverse effects - Answer: Bleeding, lethargy, muscle pain, purple toes (hands and
feet)
Report signs of bleeding/bruising
Questions (Frequently Tested) with
Verified Answers Graded A+
What are indications for anticoagulants? - Answer: MI, unstable angina, atrial fibrillation,
indwelling devices (mech heart valve) major orthopedic surgery or prolonged periods of
immobilization or long plane rides, strokes..
What are contraindications for anticoagulants? - Answer: Known drug allergy
thrombocytopenia
Pregnancy (Warfarin)
Indwelling epidural catheter (LMWH) d/t link with epidural hematoma
What are adverse rxns with Anticoagulants? - Answer: Most common: BLEEDING (localized or
systemic) for all anticoagulants!
Heparin induced thrombocytopenia (HIT)
nausea, vomiting, abdominal cramps, thrombocytopenia, bruises
Route and procedures for anticoagulation therapy - Answer: Oral and parenteral (Injection/IV)
Why is Heparin used for anticoagulation? - Answer: Preventative, heparin either unfractionated
or low molecular weight (subcutaneous -lovenox) Both can be used as preventative and DVT
treatment
It works faster than Warfarin/Coumadin.
Can be given subQ or IV
,What labwork is needed to monitor pts on Heparins - Answer: Heparin = activated PTT every 6
hrs or so, 2-3 days check a CBC d/p for platelet values.
LMWHeparins = none
What is special about the low molecular weight Heparin - Answer: They are more predictable
because they are specific for activated factor Xa. Greater bioavailability longer elimination half
life than unfractionated.
What are the reversal drugs for warfarin and Heparin? - Answer: Warfarin = Vit K
Heparin = Protamine sulfate
Heparin (pg 631 in drug guide) - Answer: Given parenteral
Preg category C
Short half life (1-2 hours)
Low molecular weights: Preg category B
Lovenox: Don't give inj near umbilicus
don't require labwork
DONT rub injection sites - could cause bruising
Heparin adverse effects - Answer: Bleeding
hematoma
anemia
thrombocytopenia (HIT)
Drug induced hepatitis (inflammation)
alopecia
osteoporosis
fever
, hypersensitivity
Know about how Coumadin (Warfarin) works for anticoagulation - Answer: Inhibits Vit K
dependent clotting factors II, VII, IX, and X. Used for clot prevention. Given PO
Important teaching for Heparin - Answer: Regular lab testing
Sx of abnormal bleeding
Wear a medical alert bracelet
Use soft toothbrushes to prevent gum bleeding. watch for nose bleeds, bloody dark stools, can
make nauseous
Monitoring lab work for Coumadin? - Answer: Coumadin, PT / INR
PT typically 11-13 seconds, therapeutic is 18 seconds
pts not on anticoagulants typically have INR value of 2-3
pts on warfarin/Coumadin value is 2 to 3.5 with a target of 3
What are the Therapeutic Levels, INR, aPTT, PT? - Answer:
Coumadin (pg 1273 in drug guide) - Answer: Given orally only
Preg category X
Monitored by PT INR
Genetic factors alter metabolism of drug
Coumadin adverse effects - Answer: Bleeding, lethargy, muscle pain, purple toes (hands and
feet)
Report signs of bleeding/bruising
