looking up these medications in a drug reference would be a great help, especially if you look at the nursing considerations because they will discuss specific protocols and lab tests required to monitor the effects of these drugs. heparin
is an anticoagulant that is given iv or subcutaneously, has an onset of action in 20-60 minutes and duration of 8 to 12 hours. this is the drug that dennis quaid's twins were overdosed with. the drug is stopped immediately and protamine is given for overdose. here is an online monograph about this drug: http://www.drugs.com/pro/heparin.html lovenox (enoxaparin sodium)
is also a anticoagulant and chemically a low-molecular-weight heparin that can only be given subcutaneously and has a peak activity in 3 to 5 hours before it is rapidly eliminated through the renal system. in order for a steady state of anticoagulation to be reached this drug must be given at a specific times each day. protamine equal to the dose is given for overdose. here is an online monograph about this drug and how to administer it: http://www.drugs.com/pro/lovenox.html coumadin (warfarin)
is another anticoagulant that is primarily given orally although there is an iv form of it. onset is 12 to 24 hours, peak action is one and a half to 4 days
and duration of action is 3 to 5 days
. vitamin k is given for overdose. here is an online monograph about this drug: http://www.drugs.com/pro/coumadin.html
heparin is the drug used in the acute hospital setting to begin immediate anticoagulation because its onset of action is immediate (within 20 minutes). ptt levels will be monitored every 6 hours to titrate the dose of heparin. coumadin is started within a day or two. coumadin needs several days for its effects to build within the persons system, so the patient may have their heparin drip going while they are getting a daily dose of the coumadin. daily pt levels will be drawn to monitor the anticoagulation effect of the coumadin. as soon as pt levels start to elevate, an indication that the dose of coumadin is effective, the heparin will be discontinued.
lovenox is given as a prophylactic
measure--to prevent the formation of a blood clot. it is commonly prescribed for postop patients as a preventative from them getting a dvt while immobile. if a patient already has a dvt it is unlikely that lovenox would be one of the drugs used to treat it. after the clot is resolved, this drug may be used later as a preventative so clots do not form again. a therapeutic dose of coumadin may also be given for that same reason.