Question

TM is a 57 year old male. He has been admitted into the hospital thromobophlebitis in the right lower leg. He was given a IV Heparin 5000 unit bolus. Following the IV bolus, heparin 5000 units was given subcutaneously every 6 hours as prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were prescribed, and a aPTT test was ordered.

1.Was TM's heparing order within the safe daily dosage range? Explain.

2. What are the various methods for administering heparin?

3. Why was a aPTT test ordered? How would you determine whether TM is withing the desired therapeutic range? Explain your answer.

After 5 days of heparin therapy, TM is prescribed oral warfarin 5mg daily. An INR test was ordered.

4. What is the pharmacologic action of warfarin? Is the warfarin dose within the safe daily dose range? Explain your answer.

Answer 1

1. Yes, the heparin order within the safe daily dosage range.

The recommended dose is 5000 units bolus and 250 units per kg 12 hourly.(Approx 60 kg person can administered 30,000 units per day.)

The patient has given an IV Heparin 5000 unit bolus. Following the IV bolus, heparin 5000 units were given subcutaneously every 6 hours. So, it is in a safe range.

2.

Heparin can be administered intravenously (Bolus, periodically or as a continuous infusion)

Or in the subcutaneous route periodically.

It can also be administered by indwelling catheters.

3.

Partial thromboplastin time (PTT) is used to measure the effects of Heparin in the body which helps in the adjustment of dose. The normal range of PTT is 25 to 35 seconds.

Heparin increases the PTT value. PTT range from 60 to 100 seconds tells the therapeutic dose of Heparin in the body.

4.

Warfarin is a class of drugs called an anticoagulant, It blocks the actions of clotting factors and stops the clot formation in the body.

Yes, the dose is safe, The Patient can take up to 10 mg of warfarin daily.

According to INR value, the dose can be modified, Therapeutic INR value for warfarin is 2 to 3.