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06.04 Warfarin (Coumadin)

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Generic Name

warfarin

Trade Name

Coumadin

Indication

venous thrombosis, pulmonary embolism, A-fib, myocardial infarction

Action

disrupts liver synthesis of Vitamin K dependent clotting factors

Therapeutic Class

Anticoagulant

Pharmacologic Class

coumarins

Nursing Considerations

• contraindicated with bleeding, severe hypertension
• can cause bleeding
• aspirin and NSAIDs can increase risk of bleeding
• azole antifungals increase effects of warfarin
• cimetadine(Tagamet) increases warfarin levels
• obtain full history of supplements and herbs
• large amounts of vitamin K may antagonize effects of warfarin
• assess for signs of bleeding
• therapeutic levels: PT 1.3-1.5, INR 2.5-3.5
• instruct patient to report any signs of bleeding
• patient should not drink alcohol
• bleeding times need to be monitored frequently
• vitamin K is antidote

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