Heparins
Heparins ( 5 Questions)
A nurse is caring for a client who develops heparin-induced thrombocytopenia (HIT) while receiving unfractionated heparin for pulmonary embolism. The nurse anticipates that the health care provider will order which of the following medications to treat this condition?
Choice A is wrong because warfarin, which is an oral anticoagulant that works by blocking vitamin K, is contraindicated in patients with HIT, as it can cause skin necrosis and limb gangrene due to microvascular thrombosis. Warfarin also has a delayed onset of action and requires monitoring of the international normalized ratio (INR).
Choice B is wrong because aspirin, which is an antiplatelet agent that works by inhibiting cyclooxygenase, is also contraindicated in patients with HIT, as it can increase the risk of bleeding and does not prevent thrombosis. Aspirin also has a long-lasting effect on platelet function and can interact with other drugs.
Argatroban, which is a direct thrombin inhibitor that works by binding to thrombin. This is because argatroban is an alternative anticoagulant that can be used for patients with HIT, as it does not cause platelet aggregation or activation. Argatroban directly inhibits thrombin, which is the enzyme that converts fibrinogen to fibrin and activates platelets.
Choice D is wrong because streptokinase, which is a thrombolytic agent that works by converting plasminogen to plasmin, is not indicated for patients with HIT, as it can cause severe bleeding complications and allergic reactions. Streptokinase also has a short half-life and requires continuous infusion.
Argatroban, which is a direct thrombin inhibitor that works by binding to thrombin. This is because argatroban is an alternative anticoagulant that can be used for patients with HIT, as it does not cause platelet aggregation or activation. Argatroban directly inhibits thrombin, which is the enzyme that converts fibrinogen to fibrin and activates platelets.
Choice A is wrong because warfarin, which is an oral anticoagulant that works by blocking vitamin K, is contraindicated in patients with HIT, as it can cause skin necrosis and limb gangrene due to microvascular thrombosis.
Warfarin also has a delayed onset of action and requires monitoring of the international normalized ratio (INR).
Choice B is wrong because aspirin, which is an antiplatelet agent that works by inhibiting cyclooxygenase, is also contraindicated in patients with HIT, as it can increase the risk of bleeding and does not prevent thrombosis.
Aspirin also has a long-lasting effect on platelet function and can interact with other drugs.
Choice D is wrong because streptokinase, which is a thrombolytic agent that works by converting plasminogen to plasmin, is not indicated for patients with HIT, as it can cause severe bleeding complications and allergic reactions.
Streptokinase also has a short half-life and requires continuous infusion.