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Anticoagulants and Narcotics

Anticoagulants and Narcotics. Prevent coagulation of thrombocytes (platelets) Side effects: bleeding, hematuria , black feces Some are photosensistive like Warfarin Antidote for Warfarin ovedose : Mephyton Monitor pts. coagulation rate with Prothrombin times.

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Anticoagulants and Narcotics

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  1. Anticoagulants and Narcotics

  2. Prevent coagulation of thrombocytes (platelets) • Side effects: bleeding, hematuria, black feces • Some are photosensistive like Warfarin • Antidote for Warfarinovedose: Mephyton • Monitor pts. coagulation rate with Prothrombin times. • Heparain is IV or Subcutaneously only?if IM will leave hole in muscle. • Heparin overdosage; antidote is Protamine sulfate

  3. Examples: heparin, Warfarin (coumadin), ASA • Plavix (clopidogrel)

  4. Anti-hyperlipidemia agents (statins) • LDL’s (bad cholesterol) above 100 mg % and total cholesterols over 200 mg % • Block the enzyme in liver’s cholesterol synthesis Side effects: HEPATOTOXIC, do liver tests Q 6 monthly to see if liver dying Upset the stomach, headaches, muscle aches

  5. Examples: Lipitor (atorvastatin) • Mevacor (pravastatin) • Pravachol (pravastatin) • Crestor (rosuvastatin) • Zocor (simvastatin)

  6. Narcotic/Opiod Analgesics • For pain management • Analgesic, sedatives, euphorics, dysphoria • Work on the CNS blocking pain receptors at target organs • CNS produces endorphins in response to pain (nature’s analgesic) • Opioid narcotics act the same way but med is derived from opium/the poppy plant

  7. Side effects; respirator depression • Habituation, tolerance, addictive liability • Very constipating (need MOM after surgery) • Mental confusion, nausea, vomiting • All are controlled substances

  8. Acetaminophen (tylenol) non narcotic OTC • Stadol powerful, IV IM patch nasal, used for severe backaches, very addictive and abused • Codeine sched. II • FentanylSched II anesthesia induction • Hydrocodone (Hycodan/Lorgesic) • Hydromorphone (Dilaudid) • Meperidine (Demerol) • Methadone (Dolophone) • Oxycodone ( OxyContin) • Percocet (oxycodone with tylenol) Percodan( if with ASA) • Pentazocine (Talwin) • Propoxyphone (Darvocet)

  9. NSAIDS (non steroidal anti inflammatory drugs) • Prostaglandins are the body’s chemicals that sensitize your pain receptors in organs. NSAIDS block prostaglandin synthesis • Antipyretics, anti inflammatory, analgesic • Stomach upsetting though

  10. Ibuprofen (Motrin, Nuprin, Advil) • Indocin (indomethacin) Naproxen (Anaprox, naprosyn, ALLEVE is OTC now) Toradol, Relafen, Daypro, Feldene Take with food or upset stomach, may cause GI bleeding for long term arthritis tx. Most gone OTC now Celebrex and Vioxx causing heart problems and going off the market

  11. Aspirin • Acetyl salicylic acid • Antipyretic, analgesic, antiinflammatory (tylenol only antipyretic and analgesic but not antiinflammatory; also it causes liver damage so warnings for kids up now) ASA safer but upsets stomach, tylenol doesn’t • Overdose of ASA tinnitus, DON’T given to kids who have chickenpox (varicella) Reyes syndrome and never give to pts taking anticoagulants for it delays blood clotting also!!!!

  12. Rheumatoid Arthritis Meds (DIMARDS)disease modifying anti rheumatic agents) • Inhibit lymphocyte migration to hot joints causing inflammation • Humira (adalimumab), Enbrel ((etanercept)

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