Question

Drugs that affect blood coagulation are used in the prevention and management of many diseases.

a. Discuss a health problem and how a specific medication that affects blood coagulation is used as a treatment.

b. A potential risk of administering medications that affect blood coagulation is an inadvertent overdose. Discuss possible assessments and interventions for this problem.

Answer 1

Answer =

* Anticoagulants = To prevent clote and fibrin formation.

- Anticoagulants prevent the extension and formation of clots by inhibiting factors in the clotting cascade and decreasing blood coagulability.

- Anticoagulants are administered when there is evidence of or likelihood of clot formation myocardial infarction, unstable angina, deep vein thrombosis and pulmonary embolism.

- Anticoagulants contraindicated with active bleeding and bleeding disorder.

A. A health problem that affect blood coagulation =

* Deep Vein Thrombosis = Venous thrombosis into deep vein, It is difficult to assess because it create in deep vein. Thrombosis convert into embolism.

Clinical features =

- lower extrimities mainly affect.

- Calf area most common site of DVT and below knee.

- Pain- Deep within muscle calf tenderness.

- Edema due to extravession.

- Swelling.

- Redness and warmethy-

* Homan sign *

Diagnostic evaluation = History physical examination.

Venography, CT- SCAN, , MRI,

- D- Dimer test.

Management =

- Do Clote Lytic.

- Do venous congestion Thin.

- Increase Venous return.

- Decrease Blood Viscocity.

- Give thrombolytic agent - Streptokinese and urokinese.

- Give anticoagulents - Heparin sodium,Enoxiperin and no massage.

- Intra luminal procedure is the surgical procedure .

B. A potential risk of administering medications that affect blood coagulation is an inadvertent overdose =

Answer = Warfarin = Not naturally present in the body.

Warfarin inhibit Vitamin K depended factors ( 2,7, 9 and 10 ) and also inhibit protein C and S.

Warfarin give by oral route.

Warfarin effect start 1-3 days .

It is not use as initiation therapy, it is use as maintainance therapy.

- It is used for long term anticoagulation and is used mainly to prevent thromboembolic condition such as thrombophlebitis, pulmonary embolism, myocardial infarction and DVT.

Blood level - Normal PT - is 11-12.5 seconds, warfarin sodium prolongs the PT the therapeutic range is 1.5 to 2 times the control range.

- Best method for monitor dose of warfarin = INR - International Normalization Ratio.

Normal INR = 1.3- 2.0 ( should be less then 1.3 )

After giving warfarin the INR shoild be 2.0-3.0 is good but more then 3.0 is indicate toxicity.

Adverse dose more then 4.5 then stop warfarin and start Antidote Vitamin K ( Phytonadione )

Most common adverse effect of warfarin - Bleeding .

Doc for warfarin induce bleedinng - FFP ( Fresh Frojen Plasma )