H ig h e r d o s e s n e u tr a liz e th r o m b in p

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Unformatted text preview: t h r o m b in . H ig h e r D o s e s n e u tr a liz e th r o m b in , p r e v e n tin g t h e c o n v e r s io n o f f ib r in o g e n t o f ib r in . P r e v e n t io n o f t h r o m b u s fo r m a t io n . P r e v e n tio n o f e x te n s io n o f e x is tin g t h r o m b i. In d ic a t io n : p r o p h y la x is a n d tr e a tm e n t o f v a r io u s t h r o m b o e m b o lic d is o r d e r s , in c lu d in g : V e n o u s T h r o m b o e m b o lis m , P u lm o n a r y e m b o li, A t r ia l fib r ila t io n w it h e m b o liz a tio n , A c u te a n d c h r o n ic c o n s u m p t iv e c o a g u lo p a t h ie s , P e r ip h e r a l a r t e r ia l t h r o m b o e m b o lis m . U s e d in v e r y lo w d o s e s ( 1 0 - 1 0 0 u n it s ) t o m a in t a in p a t e n c y o f I V c a th e t e r s ( I V f lu s h ) . C o n t r a in d ic a t io n s /P r e v e n t io n s : u n c o n tr o lle d b le e d in g , s e v e r e t h r o m b o c y t o p e n ia , o p e n w o u n d s , s e v e r e liv e r o r k id n e y d is e a s e , r e t in o p a th y . U s e w ith c a u t io n d u r in g la s t t r im e s t e r o f p r e g n a n c y a n d in t h e im m e d ia t e p o s p a r t u m p e io d . S id e E f f e c t s : - b le e d in g - a n e m ia - t h r o m b o c y t o p e n ia - r a s h e s - u r t ic a r ia D o s a g e a n d R o u t e : I V ( a d u l t s ) - I n te r m it t e n t b o lu s : 1 0 , 0 0 0 u n its , f o llo w e d b y 5 ,0 0 0 - 1 0 ,0 0 0 u n its q 4 - 6 h . C o n t in u o u s I n f u s io n : 5 ,0 0 0 u n it s ( 3 5 - 7 0 u n its / k g ) , fo llo w e d b y 2 0 , 0 0 0 - 4 0 ,0 0 0 u n it s o v e r 2 4 h r ( a p p r o x . 1 ,0 0 0 u n its /h r o r 1 5 - 1 8 u n its /k g /h r ) I V ( n e o n a t e s a n d i n f a n t s < 1 y r ) : C o n t in u o u s I n f u s io n - lo a d in g d o s e 7 5 u n its / k g , fo llo w e d b y 2 8 u n its /k g /h r. A d ju s t to m a in t a in a P T T o f 6 0 - 8 5 s e c o n d s . N u r s i n g I m p l ic a t io n s : - a s s e s s p t f o r s ig n s o f b le e d in g a n d h e m o r r h a g e . - a s s e s s p t fo r e v id e n c e o f a d d it io n a l o r in c r e a s e d t h r o m b o s is . - m o n it o r p t fo r h y p e r s e n s itiv it y r e a c tio n s ( c h ills , fe v e r, u r t ic a r ia ) . R e p o r t s ig n s to p h y s ic ia n . - m o n it o r A c t iv a t e d P a r t ia l T h r o m b o p la s t in T im e ( a P T T ) a n d h e m a t o c r it p r io r a n d p e r io d ic a lly d u r in g th e r a p y . - m o n it o r p la t e le t c o u n t e v e r y 2 - 3 d a y s t h r o u g h o u t th e r a p y . - m a y c a u s e p r o lo n g e d p r o t h r o m b in t im e ( P T ) le v e ls , in c r e a s e d s e r u m t h y r o x in e , T , r e s in a n d f a ls e - n e g a t iv e I f ib r in o g e n u p t a k e t e s ts . - m a y c a u s e d e c r e a s e d s e r u m t r y g ly c e r id e a n d c h o le s t e r o l le v e ls a n d in c r e a s e d p la s m a f r e e fa t t y a c id c o n c e n t r a t io n s . - m a y c a u s e h y p e r k a le m ia a n d e le v a t e d A S T a n d A L T le v e ls . A n tid o te : P r o ta m in e S u lfa te B e c a u s e o f t h e s h o r t h a lf - lif e , o v e r d o s e c a n o f t e n b e t r e a t e d b y w ith d r a w in g t h e d r u g . C Y T O T E C (M IS O P R O S T O L ) C l a s s if ic a t io n : a n tiu lc e r a g e n ts , c y to p r o t e c t iv e a g e n t s . A c t io n : a c t s a s a p r o s t a g la n d in a n a lo g u e , d e c r e a s in g g a s t r ic a c id s e c r e t io n a n d in c r e a s in g p r o d u c t io n o f p r o t e c t iv e m u c u s . C a u s e s u t e r in e c o n t r a c t io n s . W it h m if e p r is to n e , t e r m in a t e s p r e g n a n c y o f le s s t h a n 4 9 d a y s . In d ic a t io n s : w it h m if e p r is t o n e , f o r t e r m in a t io n o f p r e g n a n c y o f le s s t h a n 4 9 d a y s . C o n t r a in d ic a t io n s /P r e c a u t io n s : - p r e g n a n c y o r la c ta t io n ( w h e n u s e d t o p r e v e n t N S A I D - in d u c e d g a s tr ic in ju r y ) . - u s e c a u t io u s ly in p t w it h c h ild b e a r in g p o t e n t ia l; c h ild r e n < 1 8 y r ( s a f e t y n o t e s ta b lis h e d ) . - e x e r c is e e x t r e m e c a u t io n w h e n u s e d f o r c e r v ic a l r ip e n in g ( m a y c a u s e u t e r in e r u p t u r e ) . - r is k fa c t o r s a r e la te tr im e s t e r p r e g n a n c y , p r e v io u s c e s a r ia n s e c t io n o r u t e r in e s u r g e r y s u r g e r y , o r > 5 p r e v io u s p r e g n a n c ie s . - S id e E f f e c t s : - h e a d a c h e - a b d o m n a l p a in - d ia r r h e a - nausea - v o m itin g - m is c a r r ia g e D o s a g e a n d R o u t e : P O . 2 0 0 m c g 4 t im e s d a ily , w it h o r a f t e r m e a l a n d a t b e d t im e ; o r 4 0 0 m c g 2 tim e s d a ily , w ith la s t d o s e a t b e d t im e . I f in t o le r a n c e o c c u r s , d o s e m a y b e d e c r e a s e d t o 1 0 0 m c g 4 tim e s d a ily . T e r m in a t io n o f p r e g n a n c y : 4 0 0 m c g s in g le d o s e t w o d a y s a f t e r m if e p r is to n e , if a b o r tio n h a s n...
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This note was uploaded on 11/08/2010 for the course NUR 2000 taught by Professor Rn during the Spring '10 term at Florida State College.

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