Coumarins
You're watching a preview. 300,000+ students are watching the full lesson.
Included In This Lesson
NURSING.com students have a 99.25% NCLEX pass rate.
Outline
Overview
I. Overview
A. Derivative of the natural plant anticoagulant known as coumarin
B. Most commonly prescribed oral (PO)
C. Requires careful monitoring
1. Prothrombin time/international normalized ratio (PT/INR)
a. INR
1. 2.0-3.0 while taking blood thinners
b. PT
1. 11-13.5 seconds
II. Mechanism of Action
A. Inhibits vitamin K–dependent clotting factors II, VII, IX, and X
III. Indications
A. Atrial fibrillation
B. DVT / PE thrombo-prevention
C. DVT / PE treatment
D. Stroke prevention
E. Prosthetic heart valve
F. Post-MI prevention / treatment
G. Unstable angina
IV. Contraindications
A. Recent trauma
B. Active internal bleeding
C. Bleeding disorders
D. Intracranial hemorrhage
E. Severe HTN
F. Bacterial endocarditis
G. Liver failure
H. Kidney failure
V. Interactions
A. Alcohol
B. NSAIDs
C. Diuretics
D. SSRIs
E. Vitamins
F. Antibiotics
G. Foods
1. Kale
2. Spinach
3. Turnip
4. Mustard greens
5. Broccoli
6. Brussel sprouts
7. Cabbage
H. Herbals
1. Green tea
2. Ginkgo
3. Feverfew
4. Garlic
5. Cranberry
6. Chamomile
7. Ginger
VI. Side Effects
1. Bleeding
2. Red or brown urine
3. Black or bloody stool
4. Severe headache or stomach pain
5. Joint pain, discomfort or swelling (after injury)
6. Hemoptysis
7. Hematemesis
8. Bruising
Unlock the Complete Study System
Used by 300,000+ nursing students. 99.25% NCLEX pass rate.
- Full lesson outlines
- NCLEX simulator (SIMCLEX)
- 6,500+ practice questions
- 2,000+ lesson videos
- 300+ cheatsheets
200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.
Transcript
Welcome back, today we are going to discuss coumarins – specifically coumadin.
Coumadin comes from the plant derivative, coumarin. It is the most commonly prescribed oral anticoagulant. It requires monitoring via blood work in the form of PT/INR levels.
Coumadin inhibits vitamin K dependent factors 2, 7, 9 and 10.
Coumadin indication include atrial fib, DVT/PE prevention and treatment, prosthetic heart valves, post-MI prevention and treatment, stroke prevention and unstable angina. An easy way to remember this is ADDPPSU.
Contraindications include: Bleeding disorders, bacterial endocarditis, recent trauma, active intracranial bleeding, severe HTN, intracranial hemorrhage, liver and kidney failure. Can easy way to remember these is BBRASILK.
Now, coumadin has various interactions, let’s review the medication first. Alcohol, NSAIDs, diuretics, SSRIs, vitamins, antibiotics and vaccines – which all increase coumadin effects.
Food interactions for coumadin include kale, spinach, turnip, mustard greens, broccoli, Brussel sprouts, and cabbage – all of which decrease coumadin effects.
Lastly, herbal interactions include green tea, ginkgo, feverfew, garlic, cranberry, chamomile, and ginger – all of which, increase coumadin effects.
Side effects include bleeding, red/brown urine, black/bloody stools, severe headache, stomach pain, joint pain, hemoptysis, hematemesis and bruising. Do you see a trend? Every side effects include bleeding in one aspect of the body. Priority nursing concepts for a patient taking coumadin include clotting and pharmacology. Alright, let’s recap: Coumadin indication includes atrial fib, DVT/PE prevention and treatment, prosthetic heart valves, post-MI prevention and treatment, stroke prevention and unstable angina. An easy way to remember this is ADDPPSU. Contraindications include Bleeding disorders, bacterial endocarditis, recent trauma, active intracranial bleeding, severe HTN, intracranial hemorrhage, liver, and kidney failure. Can easy way to remember these is BBRASILK. Food interactions for coumadin include kale, spinach, turnip, mustard greens, broccoli, Brussel sprouts, and cabbage – all of which decrease coumadin effects. Lastly, herbal interactions include green tea, ginkgo, feverfew, garlic, cranberry, chamomile, and ginger – all of which, increase coumadin effects. Side effects include bleeding, red/brown urine, black/bloody stools, severe headache, stomach pain, joint pain, hemoptysis, hematemesis and bruising. Do you see a trend? Every side effects include bleeding in one aspect of the body.
You know now the important details regarding coumadin. Now, go out and be your best self today and as always, Happy Nursing!
Study Faster with Full Video Transcripts
99.25% NCLEX Pass Rate vs 88.8% National Average
- Full lesson outlines
- NCLEX simulator (SIMCLEX)
- 6,500+ practice questions
- 2,000+ lesson videos
- 300+ cheatsheets
200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.
Nursing School Doesn't Have To Be So Hard
Go from discouraged and stressed to motivated and passionate
pharm2
Concepts Covered:
- EENT Disorders
- Oncology Disorders
- Microbiology
- Emergency Care of the Cardiac Patient
- Vascular Disorders
- Cardiac Disorders
- Central Nervous System Disorders – Brain
- Medication Administration
- Labor Complications
- Intraoperative Nursing
- Musculoskeletal Trauma
- Respiratory Disorders
- Shock
- Infectious Respiratory Disorder
- Disorders of Pancreas
- Pregnancy Risks
- Male Reproductive Disorders
- Adult
- Basics of Chemistry
- Emergency Care of the Respiratory Patient
- Neonatal
- Newborn Care
- Hematologic Disorders
- Cardiovascular Disorders
- Sexually Transmitted Infections
- Nervous System
- Terminology
- Disorders of the Thyroid & Parathyroid Glands
- Learning Pharmacology
- Integumentary Disorders
- EENT Disorders
- Liver & Gallbladder Disorders
- Prenatal Concepts
- Postpartum Complications
- Labor and Delivery
- Dosage Calculations
- Concepts of Pharmacology
- Depressive Disorders
- Bipolar Disorders
- Anxiety Disorders
- Cognitive Disorders
- Personality Disorders
- Noninfectious Respiratory Disorder
- Disorders of the Posterior Pituitary Gland
- Upper GI Disorders
- Urinary Disorders
- Substance Abuse Disorders
- Urinary System
- Immunological Disorders
- Prefixes
- Suffixes
- Test Taking Strategies