Coumadin therapy

Intravenous antibiotics are given before and after the procedure. Endocarditis prophylaxis is recommended for six months. Coumadin type drugs should be administered at least for 45 days after the Watchman implantation procedure with an INR between two and three in combination with 100 mg aspirin. When complete endothelialization is likely with no or only little flowthrough the device, coumadin can be discontinued and clopidogrel 75 mg/day is given until six months follow-up examination. In the absence of thrombus or flow in the appendage at TEE at six months, clopidogrel is stopped and aspirin therapy 100 mg/day is continued indefinitely If thrombus formation is seen, obviously coumadin therapy is restarted. 

Before intervention heparin is administered (100 U/kg) in addition to endocarditis prophylaxis (e.g., cefuroxime, l,5g, i.v.). Endocarditis prophylaxis is repeated afterthe procedure. Aspirin (100mg, p.d.) and clopidogrel (75mg/day, p.o.) are prescribed for six months after implantation. The incidence of thrombus formation varies between devices (50). If thrombus is seen during follow-up, coumadin therapy should be commenced. 

Abnormal bleeding to this extent is not expected while receiving Coumadin therapy. 

Apart from surgical and interventional therapy of occlusive carotid artery disease, the major approach to preventing vascular disease and subsequent stroke is to pay close attention to the control of modifiable risk factors such as hypertension, smoking, diabetes, and hypercholesterolemia. Coumadin, an anticoagulant, is effective for the primary and secondary prevention of stroke in patients with atrial fibrillation. Aspirin, clopidogrel, and the combination of aspirin and cUpyridamole have been proven to be effective for secondary stroke prevention along with the antihypertensive combination of indap-amide and perindopril. 

Bicalutamide is approved for combination therapy with ui LH-RH analogue for treatment of advanced prostate cancer. Its response is measured by decreased prostatc-specific antigen levels. Adverse reactions include gynecoma.stia. breast pain, and inhibition of spermatogenesis. There is an mtetaction with coumadin. " ... 

It is used to assess patients on coumadin anticoagulant therapy, but does not appear to be a reliable measure of vitamin K status in otherwise healthy subjects. 

When IV therapy is to be discontinued, oral warfarin (Coumadin) or dicumarol is administered simultaneously. However, you must monitor lab values as heparin is gradually stopped and coumadin is added. The dose of Coumadin is adjusted based on PT values. 

Green, leafy vegetables would interfere with warfarin (Coumadin) anticoagulant therapy, not with antiplatelet medications therefore, this would not warrant intervention by the nurse. 

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