NUR 378 EXAM 1 PHARMACOLOGY
COMPLETE STUDY GUIDE 2026
◉ Explain the most significant drug-drug interactions for warfarin.
Answer: - with Heparin --> increases bleeding
- with Aspirin --> hemorrhage
- with non-aspirin antiplatelet drugs --> increases risk of bleeding
- with Acetaminophen --> increases risk of bleeding
Summary:
- Drugs that promote anticoagulation --> increases effects of
warfarin
- Drugs that promote bleeding --> increases risk of hemorrhaging
- Drugs that decrease anticoagulation --> decreases effects of
warfarin
◉ What should the nurse keep in mind and teach the client
regarding drug-drug interactions and warfarin? Answer: Clients
should be informed of the potential hazardous interactions with
drugs that promote bleeding or avoid any drug not prescribed by the
provider
,◉ What assessments and preparations should the nurse perform
before administering warfarin? Answer: - Baseline data of vitals
- PT values
- Genetic testing for variants of CYP2C9 and VKORCI
◉ How will the nurse monitor a client on warfarin? Answer: -
Monitor Prothrombin Time (PT), record results in international
normalized ratio (INR): Range 2-3
- Daily first 5 days, 2x a week next 1-2 weeks, 1x a week next 1-2
months, 1x every 2-4 weeks after
- Below = increase dosage
- Above = decrease dosage
◉ What teaching will the nurse provide for a client prescribed
warfarin? Answer: - Promote Adherence
- Know the signs of bleeding
- Know the risk of drug interactions
◉ How will the nurse assess the efficacy of treatment with warfarin?
Answer: PT results are between 2-3 INR
◉ What is the treatment for warfarin overdose? Answer: Vitamin K1
(phytonadione) antagonizes warfarin action and reverse the
overdose
,2.5 mg PO or 0.5-1 mg IV
◉ What are the expected pharmacological effects of the direct
thrombin inhibitors (Ex. dabigatran etexilate)? Answer: Binds and
inhibits thrombin in the blood to prevent the conversion of
fibrinogen to fibrin and prevent activation of factor XIII, which
prevents conversion soluble fibrin to insoluble fibrin --> overall
leads to reduced platelet formation and platelets in the blood.
◉ What are the therapeutic indications of the direct thrombin
inhibitors? Answer: - Atrial Fibrillation:
- prevents stroke and systemic embolism in patients with non-
vavular atrial fibrillation
- DVT and PE
- Knee or Hip replacement
- DVT/PE treatment
◉ What is the adverse effect common to all of the direct thrombin
inhibitors? Answer: - Bleeding
- GI disturbances: dyspepsia, gastritis-like symptoms
◉ How will the nurse monitor a client on a direct thrombin inhibitor
infusion? Answer: - Platelet count
, ◉ What teaching will the nurse provide for a client prescribed a
direct thrombin inhibitor for prophylaxis therapy? Answer: Take
with meals to lower GI disturbances
◉ What are the expected pharmacological effects of the direct factor
Xa inhibitors (Ex. rivaroxaban)? Answer: Binds directly with Factor
Xa to inhibit production of thrombin
◉ What are the therapeutic indications of the direct factor Xa
inhibitors (Ex. rivaroxaban)? Answer: - Prevent DVT and PE
following hip and knee replacement
- Prevent Stroke in clients with atrial fibrillation
- Treat DVT and PE unrelated to orthopedic surgery
◉ What is the adverse effect common to all of the direct factor Xa
inhibitors? Answer: - Bleeding
- Spinal/Epidural hematoma
◉ What is the mechanism of action by which aspirin acts as an
antiplatelet drug? Answer: Inhibits cyclooxygenase to prevent
platelets from synthesizing TXA2, which prevents promotion of
platelet activation and vasoconstriction in VSM, resulting in
decreased risk of arterial thrombosis
COMPLETE STUDY GUIDE 2026
◉ Explain the most significant drug-drug interactions for warfarin.
Answer: - with Heparin --> increases bleeding
- with Aspirin --> hemorrhage
- with non-aspirin antiplatelet drugs --> increases risk of bleeding
- with Acetaminophen --> increases risk of bleeding
Summary:
- Drugs that promote anticoagulation --> increases effects of
warfarin
- Drugs that promote bleeding --> increases risk of hemorrhaging
- Drugs that decrease anticoagulation --> decreases effects of
warfarin
◉ What should the nurse keep in mind and teach the client
regarding drug-drug interactions and warfarin? Answer: Clients
should be informed of the potential hazardous interactions with
drugs that promote bleeding or avoid any drug not prescribed by the
provider
,◉ What assessments and preparations should the nurse perform
before administering warfarin? Answer: - Baseline data of vitals
- PT values
- Genetic testing for variants of CYP2C9 and VKORCI
◉ How will the nurse monitor a client on warfarin? Answer: -
Monitor Prothrombin Time (PT), record results in international
normalized ratio (INR): Range 2-3
- Daily first 5 days, 2x a week next 1-2 weeks, 1x a week next 1-2
months, 1x every 2-4 weeks after
- Below = increase dosage
- Above = decrease dosage
◉ What teaching will the nurse provide for a client prescribed
warfarin? Answer: - Promote Adherence
- Know the signs of bleeding
- Know the risk of drug interactions
◉ How will the nurse assess the efficacy of treatment with warfarin?
Answer: PT results are between 2-3 INR
◉ What is the treatment for warfarin overdose? Answer: Vitamin K1
(phytonadione) antagonizes warfarin action and reverse the
overdose
,2.5 mg PO or 0.5-1 mg IV
◉ What are the expected pharmacological effects of the direct
thrombin inhibitors (Ex. dabigatran etexilate)? Answer: Binds and
inhibits thrombin in the blood to prevent the conversion of
fibrinogen to fibrin and prevent activation of factor XIII, which
prevents conversion soluble fibrin to insoluble fibrin --> overall
leads to reduced platelet formation and platelets in the blood.
◉ What are the therapeutic indications of the direct thrombin
inhibitors? Answer: - Atrial Fibrillation:
- prevents stroke and systemic embolism in patients with non-
vavular atrial fibrillation
- DVT and PE
- Knee or Hip replacement
- DVT/PE treatment
◉ What is the adverse effect common to all of the direct thrombin
inhibitors? Answer: - Bleeding
- GI disturbances: dyspepsia, gastritis-like symptoms
◉ How will the nurse monitor a client on a direct thrombin inhibitor
infusion? Answer: - Platelet count
, ◉ What teaching will the nurse provide for a client prescribed a
direct thrombin inhibitor for prophylaxis therapy? Answer: Take
with meals to lower GI disturbances
◉ What are the expected pharmacological effects of the direct factor
Xa inhibitors (Ex. rivaroxaban)? Answer: Binds directly with Factor
Xa to inhibit production of thrombin
◉ What are the therapeutic indications of the direct factor Xa
inhibitors (Ex. rivaroxaban)? Answer: - Prevent DVT and PE
following hip and knee replacement
- Prevent Stroke in clients with atrial fibrillation
- Treat DVT and PE unrelated to orthopedic surgery
◉ What is the adverse effect common to all of the direct factor Xa
inhibitors? Answer: - Bleeding
- Spinal/Epidural hematoma
◉ What is the mechanism of action by which aspirin acts as an
antiplatelet drug? Answer: Inhibits cyclooxygenase to prevent
platelets from synthesizing TXA2, which prevents promotion of
platelet activation and vasoconstriction in VSM, resulting in
decreased risk of arterial thrombosis
