| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Protamine sulfate 1%—IV 10 mg/mL slowly; 1 mg/100 units heparin | Overdose of heparin | Positive electrostatic charge inactivates negatively charged heparin molecules | Excessive coagulation; hypotension, bradycardia, dyspnea |
| NURSING IMPLICATIONS: Slow IV; no more than 50 mg in 10-min period; monitor VS continuously; check activated partial thromboplastin time (aPTT) for effectiveness |
| Vitamin K (Aquamephyton, Konakion)—PO, IM, Subcu 2.5–25.0 mg; 0.5–1.0 mg in newborns | Warfarin (Coumadin) hypoprothrombinemia; hemorrhagic disease in newborns | Counteracts the inhibitory effects of oral anticoagulants on hepatic synthesis of vitamin K–dependent clotting factors | Flushing, hypotension, allergic reactions; reappearance of clotting problems (high doses) |
| NURSING IMPLICATIONS: Give IV only if absolutely necessary; dilute with preservative-free 0.9% NaCl, D5W, or 5% dextrose in NaCl; protect solution from light; repeat injection may cause redness and pain; check prothrombin time (PT) for drug effect |