hospital lab - quiz 4 counseling pts

heparin sodium

Contraindication(s): Uncontrolled active bleed, history of HIT,

Warning(s): Fatal medication error; verify correct concentration is chosen, High Alert Medication

Monitor: anti-Xa levels and aPTT

Note(s): Heparin lock flush solution is intended only to maintain patency of IV devices and is NOT to be used for systemic anticoagulant therapy. UFH is often preferred in severe renal impairment because it does not require the same renal dose adjustment as LMWH and has a short half-life with rapid reversibility. Use total body weight for dosing.

Antidote: Protamine

enoxaparin sodium

BBW: Risk of hematomas and subsequent paralysis in patients receiving neuraxial anesthesia (epidural, spinal)

Contraindication(s): History of HIT (heparin-induced thrombocytopenia), active major bleed

Note(s): Common Adult Dosing:

Prophylaxis of VTE- 40 mg SC daily

Treatment of VTE- 1 mg/kg SC Q12H

Antidote: Protamine

argatroban

Note(s): Safe for use with active HIT or history of HIT; no antidote

bivalirudin/Angiomax

Note(s): Safe for use with active HIT or history of HIT; no antidote

fondaparinux/Arixtra

BBW: Risk of hematomas and subsequent paralysis in patients receiving neuraxial anesthesia (epidural, spinal)

Contraindication(s): Severe renal impairment (CrCl <30mL/min),

4-factor prothrombin complex concentrate/Kcentra

Indication(s): Bleeding:

Note:Contains factors II, VII, IX and X and Protein C and Protein S. Administer with vitamin K.

phytonadione (vit K)

Indication(s): Warfarin reversal, vitamin K deficiency

BBW: Fatal hypersensitivity reactions, including anaphylaxis

Note(s): Protect from light

protamine

Indication(s): UFH/LMWH reversal

*Heparin neutralization: 1 mg of protamine will reverse 100 units of heparin;

*Low-molecular-weight heparin neutralization: 1 mg protamine per 1 mg of enoxaparin

idarucizumab/Praxbind

Indication(s): Dabigatran reversal

desmopressin/DDAVP

BBW: Life threatening hyponatremia

octreotide

Indication(s): Acute esophageal variceal bleeding;

Side effect(s): bradycardia, hyperglycemia or hypoglycemia, cholelithiasis, biliary sludge