Question

the desired range? Explain your answer After 5 days of Heparin therapy, Mr. Moore was prescriber warfarin (Coumadin) 5 mg, by mouth daily. A PT/INR test was ordered. 3. What is the pharmacologic action of warfarin? Is the wasfarin dose within the safe daily dose range? Explain your answer. 4. What are the half-life and protein binding for warfarin? If a patient takes a drug that is highly protein bound, would there be a drug interaction? Explain your answer. PT/INR ordered for Mr. Moore? What is the desired range? Why is a 5. What serious adverse reactions could result with prolonged warfarin? of large doses of use 6. What patient teaching interventions should the nurse include? List three (3) interventions you, as the nurse, would employ 7. Months later, Mr. Moore has hematemesis. What nursing actions should be taken? 11/17

Answer 1

Ans) 3) Warfarin competitively inhibits the vitamin K epoxide reductase complex 1 (VKORC1), which is an essential enzyme for activating the vitamin K available in the body. Through this mechanism, warfarin can deplete functional vitamin K reserves and therefore reduce the synthesis of active clotting factors.

Yes, Warfarin is in safe dose range

4) It has a half-life of 36-42 hours, and circulates bound mainly to plasma albumin (99%) as well as small amounts of other plasma proteins, until it is stored in the liver for further metabolism. Its maximum effect is observed at up to 48 hours after administration. Its actions last for up to 5 days.

Plasma protein binding refers to the degree to which medications attach toproteins within the blood. A drug's efficiency may be affected by the degree to which it binds. The less bound a drug is, the more efficiently it can traverse cell membranes or diffuse.

A prothrombin time (PT) is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder; the international normalized ratio (INR) is calculated from a PT result and is used to monitor how well the blood-thinning medication (anticoagulant) warfarin (Coumadin®) is working to prevent blood.

The normal range for your PT results is: 11 to 13.5 seconds. INR of 0.8 to 1.1.

5) Warfarin 'thins the blood' by slowing down the anticoagulation effect of vitamin K, thereby increasing the time it takes blood to clot and reducing the risk of stroke. "The goal is to thin the blood enough to prevent any stroke but not too much and cause bleeding.

6) Patient teaching intervention:

- Limit vitamin k intake
- Soft toothbrush
- Electric shaver
- Take med as directed take missed doses ASAP
- Report unusual bleeding and bruising