Anticoagulants

See also the following individual entries:

Ardeparin sodium

Danaparoid sodium Action/Kinetics: Drugs that influence blood coagulation can be divided into three classes: (1) anticoagulants, or drugs that prevent or slow blood coagulation; (2) thrombolytic agents, which increase the rate at which an existing blood clot dissolves; and (3) hemostatics, which prevent or stop internal bleeding. The dosage of all agents must be carefully adjusted since overdosage can have serious consequences. The major anticoagulants are warfarin, heparin, and heparin derivatives. The following considerations are pertinent to all types. Anticoagulants do not dissolve previously formed clots, but they do forestall their enlargement and prevent new clots from forming.

Uses: Venous thrombosis, pulmonary embolism, acute coronary oc clusions with MIs, and strokes caused by emboli or cerebral thrombi. Prophylactically for rheumatic heart disease, atrial fibrillation, traumatic injuries of blood vessels, vascular surgery, major abdominal, thoracic, and pelvic surgery, prevention of strokes in clients with transient attacks of cerebral ischemia, or other signs of impending stroke.

Heparin is often used concurrently during the therapeutic initiation period. Non-FDA Approved Uses (Warfarin): Reduce risk of postconversion emboli; prophylaxis of recurrent, cerebral thromboembolism; prophylaxis of myocardial reinfarc-tion; treatment of transient ischemic attacks; reduce the risk of thromboem-bolic complications in clients with certain types of prosthetic heart valves; reduced risk of thrombosis and/or occlusion following coronary bypass surgery.

Contraindications: Hemorrhagic tendencies (including hemophilia), clients with frail or weakened blood vessels, blood dyscrasias, ulcerative lesions of the GI tract (including peptic ulcer), diverticulitis, colitis, SBE, threatened abortion, recent operations on the eye, brain, or spinal cord, regional anesthesia and lumbar block, vitamin K deficiency, leukemia with bleeding tendencies, thrombocytopenic purpura, open wounds or ulcerations, acute nephritis, impaired hepatic or renal function, or severe hypertension. Hepatic and renal dysfunction. In the presence of drainage tubes in any orifice. Alcoholism. Special Concerns: Use with caution in menstruation, in pregnant women (because they may cause hypoprothrombinemia in the infant), during lactation, during the postpar-tum period, and following cerebrovas-cular accidents. Geriatric clients may be more susceptible to the effects of anticoagulants.

Side Effects: See individual drugs.

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