ACTIVE LEARNING TEMPLATE:
Medication
Warfarin (Coumadin)
MEDICATION __________________________________________________________________________
REVIEW MODULE CHAPTER ___________
Anticoagulants Coumarins
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Interferes with hepatic synthesis of vitamin
K- dependent clotting factors
Therapeutic Use
Prevention of thromboembolic events
Complications
Medication Administration
Dermal necrosis
Cramps
Nausea
Bleeding
2-5 mg a day for 2-4 days;
adjust daily dose by results of
INR
Contraindications/Precautions
Uncontrolled bleeding
Open wounds
Active ulcer disease
Severe liver or kidney disease
Recent brain/eye/spinal injury/surgery
Interactions
Abciximab, Androgens, capecitabine, cefotetan,
chloramphenicol, clopidogrel, disulÞram, ßuconazole,
ßuoroquinolones, itraconazole, metronidazole,
thrombolytics, eptiÞbadite, tiroÞban, sulfonamides, may
rise the response to warfarin
Evaluation of Medication Effectiveness
Prolonged PT
INR of 2-4.5 without signs of hemorrhages
Nursing Interventions
Assess for signs of bleeding
and hemorrhages
Assess for evidence of
additional or increased
thrombosis
Consider Lab results
Client Education
Instruct patient to take
medication as directed
Review food high in Vitamin K
Patient should aviod IM
injections
Report any symptoms of
unusual bleeding to HCP