Drug Action – Target ADVERSE/se: Dose Dose

Aquamephyt fat-soluble vitamin. no adverse/se. Subcut, IM IV

on (Vitamin Prevention of (Adults): 10 mg.
bleeding due to antidote
K) IV O= 1-2 hypoprothrombinem
hr ia.
P = 3-6
D = 12
Nursing considerations: large dose will counteract the effect of warfin – but not
Heparin. Large doses of salicylates or broad-spectrum anti-infectives may
increase vitamin K requirements. Monitor BP HR apply pressure to venipuncture
sites for at least 5 min.. Monitor PT time.
Bile acid sequestrants, mineral oil, and sucralfate may decrease vitamin K
absorption from the GI tract. May require admission of FF Plasma in severe
bleeding because of the delayed onset of this medication. FFPlasma and
Coumadin is Antidote
Drug Action – Target ADVERSE/se: Dose Dose

antipyretic, EXFOLIATIVE DERMATITIS, , PO 50-325 mg

Aspirin nonopoid TOXIC EPIDERMAL NECROLYSIS, once daily.
analgesics/ ANAPHYLAXIS AND LARYNGEAL Prevention of
O= 5-30 min salicylates/ EDEMA. GI BLEEDING, dyspepsia, Myocardial
P = 1-3 hr Prophylaxis of epigastric distress, nausea, Infarction
D = 3-6 hr transient ischemic
attacks & MI
Nursing considerations: Advise patient to report tinnitus; unusual bleeding of gums;
bruising; black, tarry stools; or fever lasting longer than 3 days. Patients who have
asthma, allergies, and nasal polyps or who are allergic to tartrazine are at an increased
risk for developing hypersensitivity reactions. Toxicity and Overdose: Monitor patient for
the onset of tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy,
diarrhea, and sweating. If these symptoms appear, withhold medication and notify
physician or other health care professional immediately. Plavix – clopidogrel given with
Apirin, stops platelets from coagulating & responds to fatty streak bleeding!!!!! If
going to surgery you need to be off. No Lab test or antidote.
Drug Action – Target ADVERSE/se: Dose Dose

Clopidogrel antiplatelet BLEEDING, PO 75 mg once daily.

(Plavix) agent/ red of NEUTROPENIA, Acute Coronary
atherosclerotic THROMBOTIC Syndrome
O= w/in 24 hrs events (MI stroke, THROMBOCYTOPENIC PO (Adults): 300 mg
P = 3-7 days vascular death. PURPURA, GI BLEEDING, initially, then 75 mg once
D = 5 days inhibits platelet daily; aspirin 75-325 mg
aggregation. once daily should be given
concurrently.
Nursing considerations: Monitor patient for signs of thrombotic thrombocytic purpura
(thrombocytopenia, microangiopathic hemolytic anemia, neurologic findings, renal
dysfunction, fever). May rarely occur, even after short exposure (<2 wk). Requires prompt
treatment. Monitor CBC with differential and platelet count periodically during therapy.
Neutropenia and thrombocytopenia may rarely occur.
No Way to Reverse Plavix. Plavix – clopidogrel given with Apirin
Drug Action – Target ADVERSE/se: Dose Dose

Dipyridamole antiplatelet PO (Adults): 225-400

(Persantine, agent, coronary dizziness, headache, mg/day in 3-4 divided
vasodilators. hypotension, nausea. doses.
Aggranox) Decreases PO: Administer with a
platelet full glass of water at
O, P, D= aggregation by least 1 hr before or 2
UKN inhibiting hr after meals for
phosphodiester faster absorption.
ase.
Nursing considerations: Assess for signs of bleeding and hemorrhage (bleeding
gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in
hematocrit or blood pressure; Monitor CBC, platelet count.
Before meals, makes platelets slippery
Drug Action – Target ADVERSE/se: Dose Dose

Enoxaparin BLEEDING, anemia, VTE prophylaxis

(Lovenox) anticoagulant/pr thrombocytopenia (can occur up in patients
O= UKN evention of to several weeks after undergoing knee
P = 3-5hr thrombus discontinuation of therapy). replacement
D = 12 hr formation surgery-SQ-30
Heparin-induced mg q 12 hr
thrombocytopenia. may develop starting 12-24 hr
on 8th day. may reduce platelet po stop for 7-10
count to 5,000/mm3 days

Nursing considerations: No lab est or antidote. Davis Drug says Protamine

Sulfate is antidote. Long term use can contribute to osteoporosis.
Drug Action – Target ADVERSE/se: Dose Dose

Heparin anticoagulant/ BLEEDING, anemia, Small 30-40 ml 3-4 x day

O= 20-60 min PROPHYLAXIS, thrombocytopenia (can occur is Prophylactic
P = 2 hr prevents new up to several weeks after Medium 40-80 mL is for
D = 8-12 hr clots. discontinuation of therapy). High Risk prophylactic
Therapeutic – MG/KG
Antidote Protamine sulfate Heparin-induced IV SQ
Protamin is the antidote thrombocytopenia. may
Sulfate STOPS DIC- develop on 8th day. may 4 Hr Shelf Life
Production of reduce platelet count to
Platelets 5,000/mm3 HIT or HAT
Nursing considerations: Administer deep into SQ tissue. Alternate sites abdominal wall
above the iliac crest. 45° or 90° angle into a skin fold, hold skin fold throughout injection.
Do not aspirate or massage. Rotate sites frequently. Do not administer IM because of
danger of hematoma formation Assess for signs of bleeding and hemorrhage (bleeding
gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or
blood pressure; guaiac-positive stools). Notify physician if these occur. aPTT platelet
count every 2-3 days throughout therapy
Drug Action – Target ADVERSE/se: Dose Dose

Pentoxifylli blood viscosity ↓ none.major PO is 400 mg

agent/mgmt nausea, vomiting, 3xdaily w/meals.
ne (Trental) (not to exceed 400)
O= 2-4 wk – intermittent abdominal cramping. administer w/food,
chronic use. claudication CNS – dizziness, milk or antacids to
P = 2-4 hr (Vascular) – ↓blood drowsiness and decrease GI
viscosity by inhibiting headache. distress. Tabs not
D= to be crushed
platelet aggregation
and ↓ fibrinogen.
↑flexability of RBS
and levels of cAMP
Nursing considerations: monitor BPHR color and T of affected extremities.
ACTION: Increased flexability of RBC into tiny places.
Drug Action – Target ADVERSE/se: Dose Dose

Protamine antidote HYPERSENSITIVITY Diluent: May be administered

Sulfate /inactivation REACTIONS, undiluted. If further dilution is
IV O= 30awx- of heparin INCLUDING desired, D5W or 0.9% NaCl may
1min ANAPHYLAXIS, be used.Concentration: 10
P = UKN ANGIOEDEMA, AND mg/ml. Rate: Administer by slow
D = 2 hr PULMONARY EDEMA. IV push over 1-3 min infusion
Depends on Rapid infusion rate may and notify physician. No more
body result in hypotension, than 50 mg should be
temperature bradycardia, flushing, or administered within a 10-min
feeling of warmth period
Nursing considerations: Assess for allergy to fish (salmon), previous reaction to or use of
protamine insulin or protamine sulfate. Vasectomized and infertile men also have higher
risk of hypersensitivity reaction. Observe patient for s/s of hypersensitivity reaction
(hives, edema, coughing, wheezing). Keep epinephrine, an antihistamine, and
resuscitative equipment close by in the event of anaphylaxis. Lab Test Considerations:
Monitor clotting factors, activated clotting time (ACT), activated partial thromboplastin time
(aPTT), and thrombin time (TT) 5-15 min after therapy and again as necessary.
Drug Action – Target ADVERSE/se: Dose Dose

Warfarin anticoagulant/ BLEEDING PO IV (Adults): 2.5-10

(Coumadin) Prevention of the antidote is vitamin K mg/day for 2-4 days;
O= 36-72 hr thromboembolic (phytonadione, then adjust daily dose by
P = 5-7 days events. Helps inhibit AquaMEPHYTON). results of prothrombin
D = 2-5 days PT > blood clots. When taken with other time or international
13 or INR > 3.0 Prophylaxis take meds, they go first normalized ratio (INR).
means you are home drug. hard to and warfarin Initiate therapy with lower
taking too long to control accumulates in blood. doses in geriatric or
form a clot LONG Term debilitated patients.
Nursing considerations: Before administering, evaluate recent INR or PT results and
have second practitioner independently check original order. Assess patient for signs of
bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; tarry, black
stools; hematuria; fall in hematocrit or blood pressure; guaiac-positive stools, urine, or
nasogastric aspirate). Withholding 1 or more doses of medication is usually sufficient if
INR is excessively elevated or if minor bleeding occurs. If overdose occurs the antidote is
vitamin K (phytonadione, AquaMEPHYTON). no Grapefruit juice
Drug Action – Target ADVERSE/se: Dose Dose

O=
P=
D=
Nursing considerations: