DRUG CLASSIFICATION MECHANISM OF INDICATIONS SIDE EFFECTS AND DRUG NURSING

ACTION ADVERSE EFFECTS INTERACTIONS CONSIDERATION

fondaparinux Factor Xa inhibitor For subcutaneous Frequent (19%– Anticoagulants Baseline assessment
fon-dap-a-rin-ux that selectively administration 11%): Anemia, (e.g., heparin, Assess CBC, renal
Arixtra binds to only. fever, nausea. warfarin), function test. Evaluate
CLASSIFICATION antithrombin and Prevention of Occasional (10%– antiplatelet potential risk for bleeding.
PHARMACOTHERAPEUTIC: increases its Venous 4%): Edema, medications Question
Factor Xa inhibitor. affinity for factor Thromboembolism constipation, rash, (e.g., history of recent surgery,
CLINICAL: Antithrombotic Xa, inhibiting factor vomiting, insomnia, clopidogrel), trauma, intracranial
Xa, stopping blood increased wound aspirin, hemorrhage, GI bleeding.
coagulation drainage, drotrecogin alfa, Question
cascade. hypokalemia. NSAIDs (e.g., medical history as listed
Therapeutic Effect: Rare (less than 4%): ibuprofen, in Precautions. Ensure
Indirectly prevents Dizziness, ketorolac, that pt has not received
formation of hypotension, naproxen), spinal
thrombin and confusion, urinary thrombolytics anesthesia, spinal
subsequently retention, may increase risk procedures.
fibrin clot. injection site of bleeding Intervention/evaluation
hematoma, diarrhea, Periodically monitor CBC,
dyspepsia, headache esp. platelet count, stool
for occult blood (no need
Accidental overdose for
may lead to bleeding daily monitoring in pts
complications with normal presurgical
ranging from local coagulation parameters).
ecchymoses to major Assess
hemorrhage. for any signs of bleeding:
Thrombocytopenia bleeding at surgical site,
occurs rarely. hematuria, blood in stool,
bleeding from gums,
petechiae, ecchymosis,
bleeding from injection
sites.
Monitor B/P, pulse;
hypotension, tachycardia
may indicate bleeding,
hypovolemia.
Patient/family teaching
• Usual length of therapy
is 5–9 days.
• Do not take any OTC
medication (esp. aspirin,
NSAIDs).
• Report swelling of
hands/feet, unusual back
pain, unusual
bleeding/bruising,
weakness. Treatment may
increase risk of bleeding
into the brain; report
confusion, one-sided
weakness, trouble
speaking, seizures.
Treatment may
increase risk of GI
bleeding; report bloody
stool, vomiting up blood;
dark, tarry
stools.