CJ Warfarin
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School
Collin County Community College District *
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Course
2430
Subject
Medicine
Date
Feb 20, 2024
Type
docx
Pages
2
Uploaded by SargentOtter8964
Part 2 Patient-Specific Information
DRUG
Time Due
: 1600
Dose
: 2.5 mg
Frequency
: daily
Route
: PO
Administration Instructions (specific to route
): administer same time each day; take missed dose ASAP on same day, do not double dose to make up for missed dose
REASON
What is this medication's goal/expected outcome (therapeutic effect
)? Prevention of thromboembolic events; prolonged PT/INR without signs of hemorrhage
What evidence from the patient’s chart supports the need for this medication? (i.e., vitals signs, assessment, lab data, medical history, etc.). Pt is short of breath and fatigued, so little activity is being done, which may lead to venous stasis and venous thrombosis
SAFETY
Is this a home medication? If Y is the dose the same
? New
Is the ordered dose safe (according to the safe/usual dose range
)? Yes
What labs should be assessed prior to administration? Include lab name and client’s lab results (even if normal
). Monitor PT/INR (no labs)
Is a dose adjustment required based on the client’s lab results
? No
Based on your client’s other medications, are there any drug-to-drug interactions
? Spironolactone, amiodarone, furosemide
Does your client have any of the known contraindications, black box warnings, or adverse effects associated with this medication? (Support with evidence) If Y, how will you manage these risks
? Nausea, hypertension- watch these in pt to make
sure they do not worsen after administration
Is the drug safe to administer? Y/N and Why
? (
Support
with evidence) yes- safe dose, right indication, pt is prone to VTE; no serious side effects (med can still be given with these s/e)
EVALUATION
Did this medication achieve the desired outcome (provide evidence)?
What labs/vital/assessment need to continue to be monitored after the drug is administered?
PT/INR
Part 1 Drug-Specific Information
Name(Generic/Brand)
Warfarin/Jantoven
Class (Pharm/Therapeutic)
P: coumarin/Vitamin K antagonist T: anticoagulant
Mechanism of Action
Inhibit vitamin-K dependent activation of clotting factors II, VII, IX, and X, formed in the liver; inhibits anticoagulant proteins C and S
Onset & Peak
PO- O: 36-72 hr P: 5-7 days
Indications
Prophylaxis and treatment of venous thrombowmbolic disorders (DVT/PE) and embolic complications from afib or cardiac valve replacement; reduce risk of systemic embolism after MI
Drug Library safe/usual
dose range
2-5 mg/day (2-4 days); adjust daily dose by INR levels
Drug-to-Drug Interactions
Acetaminophen (inc bleeding); allopurinol, amiodarone, beta blockers, furosemide, metronidazole, NSAIDs, salicylates, SSRIs, thyroid drugs (increase anticoagulant effect); barbiturates, carbamazepine, spironolactone, vitamin K, haloperidol
(reduce PT/INR- reduce anticoag effect); oral antidiabetic (increase hypoglycemic response)
Most Common & Serious
Adverse Effects
Vasculitis, abdominal pain, N/V/D, hemorrhage, hepatitis, alopecia, pruritis, dermal necrosis, chills, anaphylactic reactions
Contraindications
Black Box Warnings
Hypersensiticity; active bleeding (GI, GU, or respiratory tract); aneurysm; dissecting aorta; cerebrovascular hemmorahe, severe HTN, pericarditis; recent surgery with large open areas; risk of nonadherence (alcoholism/psychosis); kidney dz pt;
Patient Education
Teach measures to prevent bleeding; avoid OTC products with aspirin/salicylates; avoid activities that may result in traumatic injury; avoid extra intake of vitamin K (decrease anticoagulant effects; consistent intake of vitamin K); inform all HCP about taking warfarin; report serious illness (severe diarrhea, infxn, fever); report unusual bleeding
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