Indication International Normalization Ratio INR Therapeutic Range Venus

Indication international normalization ratio inr

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herbals or vitamins taken. Indication International Normalization Ratio (INR) Therapeutic Range Venus thrombosis Pulmonary Embolism 2.3-3.0 7 7 7
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Prevention of systemic embolism Tissue heart values Acute MI Atrial Fibrillation Recurrent embolism Mechanical heart valve 2.5-3.5 Warfarin may impact other laboratory tests ALT, AST Increase INR, PT, PTT Increase theophylline False decrease Foods and supplements that impact Warfarin Grapefruit and Cranberry products Green leafy vegetables must be kept consistent in the diet Garlic Ginger Gingko Biloba Feverfew Fish oil Turmeric St John’s Wort Chondrotin sulfate Vitamin supplements Be sure to assess alcohol intake and vegetable intake especially vegetables high in vitamin K such as kale, parsley, collards, spinach, turnip greens, mustard greens, collard greens and beet greens. Heparin Unfractionated heparin (UFH) is an older form that has been used in clot prevention for many years. It is usually used in the hospital setting as a treatment for acute issues such as DVT, PE, MI, Stroke, or atrial occlusion. This can also be given prophylactically prior to surgery. Check with your institution as to the proper procedural use. Side effects are more significant with UFH and include an increased chance of bleeding as well as pain and bruising at the injection site. Patients will usually get switched to an LMWH due the high side effect profile of UFH. Monitoring aPTT begins 3-4 hours after initiation and doses adjusted accordingly. What to monitor Laboratory Test What it measures Results Activated partial prothrombin time - aPTT Monitors intrinsic pathway of thrombin, factor Xa, used in Heparin therapy Normal is 25-41 On Heparin results 19 7 19, 28
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may be 1.5 -2 times normal Prothrombin time - PT Monitors extrinsic pathway and Vitamin K dependent clotting Factors VII, X, and II. Used in Warfarin therapy. Reported at INR International Normalization Ratio - INR Mathematical equation used to measure PT test and the time it takes blood to clot. Used in Warfarin therapy. 2-3.5 if taking anticoagulants Heparin Type Monitoring Parenteral Heparin IV, Full dose Subcutaneous aPTT every 6 hours Daily platelets for HIT Daily Hemoglobin for hemorrhage Check stool for occult blood Subcutaneous Heparin All low dose UFH CBC with platelets if side effects occur Assess for ecchymosis, purpura, CNS changes, headache, stool for occult blood Subcutaneous Heparin Standard UFH; fixed doses, IV aPTT Platelets every 2-3 days from day 4 until 14 or until discontinued LMWH Does not effect aPTT The Heparins SUBCLASS GENERIC NAME TRADE NAME Heparin heparin sodium generic LMWH enoxaparin sodium Lovenox dalteparin Fragmin tinzaparin Innohep Heparinoids danaparoid Orgaran fondaparinux AriXtra Use of Heparin Heparin Prevent VTE during surgery, prophylaxis and treatment of PE, atrial fibrillation with embolism, acute and chronic DIC, prevent clotting during surgery, prevention of 7 7
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arterial embolism, anticoagulant in blood transfusions, anticoagulant in blood transfusions, extracorporeal circulation, dialysis procedures. Not recommended for
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