What happens if your patient has taken TOO much Coumadin? The antidote for Coumadin is…VItamin K! You can also give FFP (fresh frozen plasma) or prothombin complex concentrate…these basically include those clotting factors that Coumadin exerts its effects on. How does Coumadin work? Coumadin is a PO drug that inhibits the synthesis of clotting factors, mainly the ones related to Vitamin K (Factors II, VII, IX and X and proteins C and S…but you probably don’t need that much detail!).

But in general, if you go with 2.0-3.0, you’ll be in the right ballpark when it comes to your Med/Surg exams and NCLEX. Note that there are a few conditions which have a slightly higher range, so if you work in a cardiac unit some of your patients may have a goal of 2.5-3.5 (depending on the type of valve replacement). When the INR is within this range, we say “the INR is therapeutic” meaning that the higher-than-normal INR is expected AND desired. The dose for Coumadin varies and is constantly adjusted by the pharmacy based on the INR with a target range typically 2.0-3.0). Warfarin/Coumadin: If you’ve heard some rumors about Coumadin being rat poison, you heard right! Not that it actually “poisons” rats, but the drug does cause the poor creatures to bleed out…it’s a very effective “blood thinner” in that regard! Note, however, that Coumadin doesn’t actually “thin” the blood….the term “blood thinner” is used as a broad term for meds that reduce blood clots, but what Coumadin actually does is lengthen the amount of time it takes for a blood clot to form. You’ll be using a fair amount of each of these, so it’s important to understand what they are and the nursing implications for each of them. The traditional anticoagulants are Warfarin/Coumadin, Heparin and Lovenox/Enoxaparin. Let’s break each of these down and talk about them in excruciating detail…ok just kidding…how about the highlights? And if a blood clot is already formed, we go with clot-busting drugs (like TPA). In general, we tend to call these “blood thinners” even though, technically, they don’t actually “thin” the blood. To prevent blood clots, we have a two-pronged approach: anticoagulants (like Coumadin or Heparin) and anti-platelet drugs (like Plavix). In this article, we’ll talk about what you need to know about anticoagulants for nursing school. So, it makes perfect sense that we want to prevent blood clots AND treat them when they occur. They can restrict or even completely block blood flow to organs and extremities, causing things like pulmonary embolism, heart attack, stroke, ischemic bowel and even loss of limbs.

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