Generic

Name
Brand
Name
Warfarin
Sodium
Coumadin

Classification

Anticoagulant

Indication

Contraindicati
on

Mechanism Of
Action

Adverse Reaction

Nursing
Considerations

Prevention of
recurrent TIAs

hypersensitivit
y; hemorrhagic
tendencies or
blood
dyscrasia;
recent surgery;
peptic ulcer;
severe
hypertension;
bacterial
endocarditis;
cerebrovascul
ar disorders;
psychosis;
senility;
aneurysms;
pericarditis;
pericardial
effusion;
eclampsia;
pre-eclampsia;
threatened
abortion;
alcoholism;
severe renal
and hepatic
impairment;

Interfere with the

production of
certain blood
components that
are necessary for
the formation of
blood clots.

hypersensitivity,
rash, alopecia,
diarrhea, drop in
hematocrit, purple
toes syndrome, skin
necrosis, jaundice,
nausea, vomiting,
hepatic dysfunction,
pancreatitis,
increased LFT.

Do not use drug if

patient is pregnant
(heparin is
anticoagulant of
choice); advise patient
to use contraceptives.

Warfarin inhibits
synthesis of vit Kdependent
coagulation factors
VII, IX, X and II
and anticoagulant
protein C and its
cofactor protein S.
No effects on
established
thrombus but
further extension
of the clot can be
prevented.
Secondary embolic
phenomena are
avoided.

Monitor PT ratio or
INR regularly to adjust
dosage.
Administer IV form to
patients stabilized on
Coumadin who are not
able to take oral drug.
Dosages are the
same. Return to oral
form as soon as
feasible.
Do not change brand
names once
stabilized;
bioavailability may be
a problem.
Keep ready vitamin K
incase of overdose.

pregnancy.

Generic
Name
Brand

Classification

Indication

Contraindic
ation

Mechanism Of
Action

Adverse Reaction

Nursing Consider
ations

Name

Salicylate
Aspirin

Anticoagulants,
Antiplatelets &
Fibrinolytics
(Thrombolytics)

TIAs in
men:1,300
mg/day in
divided doses
(650 mg bid or
325 mg qid).

For pain
onintegumentary
structures,myalgi
a,neuralgia,head
ache,dysmenorr
hea,gout.
Arthritis, SLE,
acute rheumatic
fever

Hypersensiti
vity to
salicylates,
severe
anemia,
history
of blood
coagulation
defects,
vitamin K
deficiency, 1
week before
and after
surgery, preg
nancy in the
last
trimester.

Prevent blood
coagulation due to
hypertension (narrow
blood vessels may
cause blood to
aggregate)
Exhibits
antipyretic, antiinflammatory and
analgesic effects.
The antipyretic
effect is due to an
action on the
hypothalamus,
resulting in heat
loss by
vasodilation of
peripheral blood
vessels. Antiinflammatory
effects are
mediated by a
decrease
in prostaglandin
synthesis. It also
decreases platelet
aggregation

GI: dyspepsia,
heartburn, anorexia,
nausea, epigastric
discomfort, potentiatio
n of peptic ulcer

Assess for pain:

type, location and
pattern

Allergic:
Bronchospasm,
asthma-like
symptoms,
anaphylaxis, skin
rashes, urticaria

Monitor renal,
LFTs and CBC

Hematologic:
prolongation of
bleeding time,
thrombocytopenia,
leucopenia,
Other: Thirst, fever,
dimness of vision

Note for asthma

Determine history
of peptic ulcers or
bleeding
tendencies.
Precautions: Do
not use in children
with chicken pox or flu
symptoms
Lactation Mild
diabetes, erosive
gastritis, bleeding
tendencies, liver or
kidney disease