Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)
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Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT)
Definition/Etiology:
- N/A
Pathophysiology:
- Medication-induced coagulopathies
- Coumadin
- Platelet inhibitors
- Heparin
Noticing: Assessment & Recognizing Cues:
- Bleeding
- Bruising
- Petechiae
- Hematoma
Interpreting: Analyzing & Planning:
- Complete Blood Count
- Red Blood Cells
- Hemoglobin
- Hematocrit
- Platelets
- Coagulation panel
- PT/INR
- PTT
- Anti Xa level
- Rule of “10”
- 10 letters= coumadinpt
- 10 letters=heparinptt
Responding: Patient Interventions & Taking Action:
- Platelet inhibitors= stop; platelet infusion
- Coumadin= vitamin K
- Heparin = protamine sulfate
- HIT= Direct thrombin inhibitor
Reflecting: Evaluating Patient Outcomes:
- Bleeding minimized/stopped
- Dose/type of medication adjusted
- Education: s/s for bleeding
Linchpins (Key Points):
- Rule of 10s
- Coumadin= PT/INR; Vitamin K
- Heparin= PTT; protamine sulfate
- HIT=direct thrombin inhibitor
- Antiplatelet= Plt; stop
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Transcript
References
- Baroletti, S. A. & Gladhaber, S. Z. (2006). Heparin-induced thrombocytopenia. Circulation, 114, e355-e356. doi: 10.1161/CIRCULATIONAHA.106.632653.
- Patriquin, C. & Crowther, M. (2011). Treatment of warfarin-association coagulopathy with vitamin K. Expert Review of Hematology, 4(60), 657-667. doi: 10.1586/ehm.11.59.
- Kamath, P. S. (2022). Management of antiplatelet agents in patients undergoing endoscopic procedures. https://www.uptodate.com/contents/management-of-antiplatelet-agents-in-patients-undergoing-endoscopic-procedures.
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Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)