Question

Anticoagulant and Thrombolytic Drugs .

Rita Simms is a 28-year-old Caucasian woman. She is being discharged from the hospital today after a recent deep venous thromboembolism. She is being discharged with a prescription for warfarin (Coumadin) 5 mg with directions to take one tablet daily at 5 p.m. The physician has asked the nurse to complete discharge counseling with Ms. Simms.

1. How often will Ms. Simms need her prothrombin time and international normalized ratio tested?

2. What are the signs of warfarin overdosage?

3. What should Ms. Simms be told about starting new medications?

Answer 1

1. Ms. Simms should testing the prothrombin time and INR after few days or weekly. Once the dose is stable testing can be done after 2-3 week.

2. Signs of warfarin overdose-

a. severe headache, dizziness
b. Heavy bleeding after any injury
c. Heavy bleeding during menstruation
d. Red spot on skin
e. Dark color urine and stool

3. Instructions before start medication:-

▪Stay touch with physician while you are taking warfarin. Contact immediately if notice any side effects.
▪You should take medicine exactly as directed and at same time daily. Don’t miss dose.
▪Avoid medications that can interact with warfarin. like aspirin, antibiotics and Paracetamol.
▪Avoid alcohol while taking warfarin because alcohol can increase INR.
▪Regulate the Vitamin K diet. like green vegetables and grapes.

Vitamin K is antidot of warfarin