Summary NR 566 Final Exam Review. WEEK 5 & 7

Week i5 iReview Chapter i18: iDrugs iAffecting ithe iHematopoietic iSystem 1. iAnticoagulants i(oral i& iparenteral) Oral iAnticoagulants ▪ Warfarin i(Coumadin): iInhibits isynthesis iof ivitamin iK-dependent iclotting ifactors iX, iIX, iVII, iand iII i(prothrombin) ▪ Pharmacokinetics ▪ Well-absorbed iwhen itaken iorally ▪ Metabolized iby iCYP i1A2 iand i2C9 ▪ Half-life iof i3 ito i4 idays ▪ Precautions iand icontraindications ▪ Pregnancy icategory iX ▪ Use icautiously iin ipatients iwith ifall irisk, idementia, ior iuncontrolled ihypertension. ▪ Avoid iin ihypermetabolic istate. ▪ The imajor iadverse idrug ireaction iis ibleeding i(Antidote iis ivitamin iK) ▪ Many idrug iinteractions, iincluding i(but inot ilimited ito): ▪ Antiplatelet idrugs ▪ Thrombolytic idrugs ▪ Oral icontraceptives, icarbamazepine, iVitamin iK-containing ifoods, ietc. ▪ Clinical iuse iand idosing ▪ Drug iof ichoice ifor ideep ivein ithrombosis i(DVT) iand ipulmonary iembolism i(PE) ▪ Start iat i5 img iper iday i(7.5 img/d iif iweight igreater ithan i80 ikg). ▪ Consider ilower idose iin ithe ifollowing isituations: ▪ Older ithan i75 iyears ▪ Multiple icomorbid iconditions ▪ Elevated iliver ienzymes ▪ Changing ithyroid istatus ▪ Dose ito imaintain iinternational inormalized iratio i(INR) ibetween i2 iand i3.