Anticoagulants injectable

The nurse must apply prolonged pressure to needle or cadieter sites after venipuncture, removal of central or peripheral IV lines, and IM and SC injections. Laboratory personnel or tiiose responsible for drawing blood for laboratory tests are made aware of anticoagulant tiierapy because prolonged pressure on die venipuncture site is necessary. All laboratory requests require a notation stating die patient is receiving anticoagulant tiierapy. 

Avoid IM injections while receiving anticoagulant therapy. 

Anticoagulant drugs include heparin and warfarin (Coumadin ) —agents used to prevent deep vein thrombosis. They are also used to prevent formation of emboli due to atrial fibrillation, valvular heart disease, and other cardiac disorders. Heparin, which is not absorbed by the gastrointestinal tract, is available only by injection its effect is immediate. 

Inject subcutaneously or IM when possible. In older children and adults, inject IM in the upper outer quadrant of the buttocks. In infants and young children, the anterolateral aspect of the thigh or the deltoid region is preferred. When IV administration is unavoidable, inject very slowly, not exceeding 1 mg/min. Anticoagulant-induced prothrombin deficiency in adults 2.5 to 10 mg or up to 25 mg (rarely, 50 mg) initially. Determine subsequent doses by prothrombin time (PT) response or clinical condition. If in 6 to 8 hours after parenteral administration (or 12 to 48 hours after oral administration), the PT has not been shortened satisfactorily, repeat dose. If shock or excessive blood loss occurs, transfusion of blood or fresh frozen plasma may be required. 

Acute DVT and PE treatment In patients with acute symptomatic DVT and in patients with acute symptomatic PE, the recommended dosage of fondaparinux is 5 mg (body weight less than 50 kg), 7.5 mg (body weight 50 to 100 kg), or 10 mg (body weight greater than 100 kg) by subcutaneous injection once daily. Continue fondaparinux treatment for at least 5 days until a therapeutic oral anticoagulant effect is established (international normalized ratio [INR] 2 to 3). Initiate concomitant treatment with warfarin as soon as possible, usually within 72 hours. The usual duration of administration of fondaparinux is 5 to 9 days. 

Epidural/Intrathecal- Presence of infection at the injection microinfusion site concomitant anticoagulant therapy uncontrolled bleeding diathesis parenterally administered corticosteroids within a 2-week period, other concomitant drug therapy or medical condition that would contraindicate the technique of epidural or intrathecal analgesia acute bronchial asthma upper airway obstruction. 

Heparin is prescribed on a unit (lU) rather than milligram basis. Tlie dose must be determined on an individual basis. Heparin is not absorbed after oral administration and therefore must be given parenterally. Intravenous administration results in an almost immediate anticoagulant effect. There is an approximate 2-hour delay in onset of drug action after subcutaneous administration. Intramuscular injection of heparin is to be avoided because of unpredictable absorption rates, local bleeding, and irritation. Heparin is not bound to plasma proteins or secreted into breast mUk, and it does not cross the placenta. 

Contraindications Epidural contraindicated in those patients with bleeding diathesis or infection at the injection site, those receiving anticoagulation therapy... 

Contraindications Hypersensitivity to esther local anesthetics, sulfites, PABA, infection or inflammation at the injection site, bacteremia, platelet abnormalities, thrombocytopenia, increased bleeding time, uncontrolled coagulopathy, anticoagulant therapy, sulfonamide therapy. 

Intra-arterial injection of thiopentone is a serious complication as crystals of the thiobarbiturate can form in the arterioles and capillaries, causing intense pain, vasoconstriction, thrombosis, and even tissue necrosis. Accidental intra-arterial injections should be treated promptly with intra-arterial administration of a vasodilator (papaverine 20 mg) and lignocaine (lidocaine) Note leave the needle/cannula in the artery), as well as a regional anaesthesia-induced sympathectomy (stellate ganglion block, brachial plexus block) and anticoagulation with intravenous heparin. The risk of ischaemic damage is much higher with a 5% solution and the use of this concentration is not recommended. 

The LMWHs appear to be as effective as unfractionated (mixed) heparins, but they offer certain advantages. For example, LMWHs can be administered by subcutaneous injection into fat tissues, thereby decreasing the need for repeated intravenous administration. Subcutaneous administration offers an easier and more convenient route, especially for people who are being treated at home or as outpatients.98 118 Dosing schedules of LMWHs are typically easier (once per day), compared to 2 or more daily injections of unfractioned heparin.132 The anticoagulant effects of LMWHs are also more predictable, and... 

Inhibition of immune hemolysis by berberine was described by Tanaka (505). Subcutaneous or intravenous injections of berberine either in single doses or repeatedly did not affect the number of erythrocytes, leukocytes, and the hemoglobin level of intact rabbits (506). In rabbits, with anemia induced by phenylhydrazine and toluenedia-mine, berberine had an antianemic effect. Hasegawa and Tanaka (507) did not observe any effect of berberine on the production of plasma cells. It decreased the anticoagulant action of heparin in dog and human blood in vitro (508). Morthland (509) carried out a spectrophotometric study of the interaction of nucleic acids with aminoacridine or with other basic stains including berberine. 

Heparin is administered intravenously at the start of a PPI procedure either as a standard bolus injection or, as more appropriately, a weight-adjusted dose regimen. No consistent dosing regimen has been tested in a well-controlled study. The anticoagulant effect of heparin during PPI should be monitored by the activated clotting time (ACT). 

Heparin [HEP a rin] is an injectable, rapidly-acting anticoagulant that is often used acutely to interfere with the formation of thrombi. 

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