Clinical Medications Worksheets Generic Name

Xarelto

Peak
Unknown

Trade Name Rivaroxaban Onset

Unknown

Classification
Anticoagulant

Dose
10mg

Route
PO

Time/frequency
0900

Duration
Unknown

For IV meds, compatibility with IV drips and /or solutions Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity to the active substance or to any of the excipients; clinically significant active bleeding; hepatic disease associated with coagulopathy and clinically relevant bleeding risk including cirrhotic patients with Child Pugh B and C; pregnancy and breast feeding.

Mechanism of action and indications (Why med ordered) Prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery.
Rivaroxaban is a highly selective direct factor Xa inhibitor with oral bioavailability. Inhibition of Factor Xa interrupts the intrinsic and extrinsic pathway of the blood coagulation cascade, inhibiting both thrombin formation and development of thrombi. Rivaroxaban does not inhibit thrombin (activated Factor II) and no effects on platelets have been demonstrated.

Common side effects

Anaemia, dizziness, headache, syncope, eye haemorrhage, tachycardia, hypotension, haematoma, epistaxis, gastrointestinal tract haemorrhage, gastrointestinal and abdominal pains, dyspepsia, nausea, constipation, diarrhoea, vomiting, pruritus, rash, ecchymosis, pain in extremity, urogenital tract haemorrhage, fever, peripheral oedema, decreased general strength and energy, increase in transaminases, post-procedural haemorrhage, contusion, wound secretion.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
azole-antimycotics (such as ketoconazole, itraconazole, voriconazole and posaconazole) or HIV protease inhibitors (e.g. ritonavir). These active substances are strong inhibitors of both CYP3A4 and P-gp and therefore may increase rivaroxaban plasma concentrations to a clinically relevant degree (2.6

Lab value alterations caused by medicine

CR levels PT, PTT, INR

Be sure to teach the patient the following about this medication

Watch for Excessive bleeding/Bruising, Look at CBC and Kidney Functioning, Do not shave, Take with or Without food.

fold on average) which may lead to an increased bleeding risk Care is to be taken if patients are treated concomitantly with medicinal products affecting haemostasis such as non-steroidal anti-inflammatory medicinal products (NSAIDs), acetylsalicylic acid, platelet aggregation inhibitors or other antithrombotic agents. For patients at risk of ulcerative gastrointestinal disease an appropriate prophylactic treatment may be considered

Nursing Process- Assessment (Pre-administration assessment)

Not recommended: in patients receiving concomitant systemic treatment with strong concurrent CYP3A4- and P-gp-inhibitors, i.e. azole-antimycotics or HIV protease inhibitors; in patients with severe renal impairment (creatinine clearance <15 ml/min); due to lack of data: in patients below 18 years of age, in patients undergoing hip fracture surgery, in patients concomitantly treated with dronedarone. Use with caution: in patients with severe renal impairment (creatinine clearance 15 - 29 ml/min) or with renal impairment concomitantly receiving other medicinal products which increase rivaroxaban plasma concentrations; in patients treated concomitantly with medicinal products affecting haemostasis or with strong CYP3A4 inducers; in patients with increased bleeding risk; when neuraxial anaesthesia or spinal/epidural puncture is employed. In patients at risk of ulcerative gastrointestinal disease prophylactic treatment may be considered.

Assessment Why would you hold or not give this med?

If Client has elevated Creatnine levels.

Evaluation venous thromboembolism

Prevention of