00:00 / 00:00
|DRUG NAME||Unfractionated heparin;|
Low molecular weight heparin (LMWH): enoxaparin (Lovenox), dalteparin (Fragmin), tinzaparin (Innohep)
|MECHANISM OF ACTION||Enhance the activity of antithrombin III → inhibit Factor Xa and Factor IIa (thrombin) → stop coagulation cascade|
|ROUTE(S) OF ADMINISTRATION|
|CONTRAINDICATIONS AND CAUTIONS|
|NURSING CONSIDERATIONS for ANTICOAGULANTS: HEPARINS|
|ASSESSMENT AND MONITORING||Unfractionated heparin, LMWH|
Focused baseline assessment
|CLIENT EDUCATION||Purpose of medication|
LMWH (e.g., enoxaparin) self-administration
Anticoagulants are medications that work by interfering with the functional clotting factors in the coagulation cascade, and are used to prevent the formation of thrombi, or blood clots, and are used to prevent or treat thromboembolic events, such as deep vein thrombosis, pulmonary embolism, ischemic stroke, transient ischemic attack, coronary artery disease or myocardial infarction.
They're also used in clients with coagulation disorders, including antiphospholipid syndrome and disseminated intravascular coagulation; as well as in clients who underwent cardiac valve replacement or coronary angioplasty; and during surgical procedures like cardiopulmonary bypass, percutaneous coronary intervention, extracorporeal membrane oxygenation, and in clients undergoing dialysis.
Among the most important anticoagulants are heparins. These include unfractionated heparin, which is derived from porcine sources, and can be administered intravenously or subcutaneously; as well as low molecular weight heparins or LMWHs, which are synthetic analogs of certain portions of the heparin molecule. These include enoxaparin, dalteparin, and tinzaparin, and are given subcutaneously.
Once administered, heparins work by binding to and enhancing the activity of antithrombin III, which is an anticoagulant protein synthesized by the liver.
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