Heparin Vs. Warfarin
Anticoagulants, their job is to slow down and the clotting process not to break up already formed clots
Warfarin
How it works
Antagonize vitamin K which prevents the synthesis of 4 coagulation factors VII, IX, X and prothrombin
Uses
Treatment of venous thrombosis
Treatment of venous thrombosis in people with A fib
Prevention of recurrent MI, TIA, PE and DVT
Side Effects
Fever
Diarrhea
Rash
Hemorrhage
Hematuria
Pharmacokinetics
Onset: 12-24 hours SLOW Duration: 3-5 days LONG
Routes: PO q day at the same time daily
Labs: AST/ALT, PT INR
Antidote: Vitamin K
Complications
Hemorrhage (observe for bleeding, bruising, black stools, VS)
Hepatitis (monitor for jaundice)
Patient Teaching
Diet: Foods high in Vitamin K may decrease effectiveness. No green leafy vegetables, alcohol or grapefruit juice
Avoid sitting for long periods of time
Stop the medication 5-7 days before having surgery or dental work
Avoid taking Aspirin, acetaminophen, glucocorticoids and sulfonamides (increase bleeding)
Phenobarbital, Dilantin, oral contraceptives (decrease effectiveness)
Wear a medical alert tag or carry an ID card stating that you take warfarin.
Use an electric razor Soft bristle tooth brush No contact sports
Heparin
How it works
Prevents clotting by activating antithrombin, indirectly inactivates thrombin and factor Xa.
Uses
Clots (PE)
Prophylaxis against postoperative DVT development
Treat DIC
Side Effects
Fever
Diarrhea
Rash
Thrombocytopenia
Pharmacokinetics
Onset: less than an hour (SUBQ) FAST
Duration: few hours SHORT
How given: Must be given by SUB Q or IV because it can’t be absorbed by the GI tract.
***If given Sub Q make sure to rotate injection sites
Labs: aPTT, platelets Antidote: protamine sulfate
(give slowly IV)
Complications
Hemorrhage (observe for bleeding, bruising, black stools, VS)
HIT (Heparin Induced thrombocytopenia)
Patient Teaching
No contact sports
Use an electric razor
Avoid Aspin, NSAIDs and salicylates
Soft bristle tooth brush
May bleed more easily for several days even after discontinuing warfarin
Contraindications for Warfarin: Pregnancy, thrombocytopenia, eye brain or spinal cord surgery, vit K deficiencies, liver disorders alcohol use disorders