The anticoagulation clinic is set up for the purpose of monitoring the INR of patients recieving Coumadin therapy. Patients referred to the clinic will be followed on a regular basis by a Registered Nurse (RN) or Licensed Practical Nurse (LPN) assigned to the clinic. These nurses have been educated as to the mechanisms of coagulation, the pharmacology of Coumadin, the indications and contraindications for the use of Coumadin and the risk factors associated with Coumadin. The nurses in the clinic will monitor and, with the physician, adjust anticoagulation therapy according to established protocol.
New patients to the clinic will have a scheduled education visit with the nurse to include the following information:
- booklet on Coumadin
- risks of Coumadin
- when to call the office
- signs of Coumadin complications (bleeding, bruising)
- Vitamin K foods that affect Coumadin
- dosing schedule including pill size and time of day to take medication
- over the counter medications and antibiotics which can affect Coumadin
- purpose and duration of Coumadin therapy
- scheduled appointments for INR follow up, dose range and adjustments of daily dose
- INR measurement with explanation of results
- written daily dosing schedule
Established patients will have a scheduled follow up appointment to monitor the INR and adjust the dose accordingly. Each follow up visit will include:
- changes in medications since last visit
- bleeding problems since last visit
- verification of dose
- any diet questions or changes
- missed doses
- the day's INR and dose adjustment
- written instructions to include the date and time of the next visit
All patients will have an office visit with the ordering physician at least every three months while on anticoagulation therapy. All patients are instructed to call the clinic to notify a change in medication or to report a potential complication (such as bleeding).
For more information on Coumadin.
Selected foods high in Vitamin K content
- mayonnaise
- oils (canola, salad, soybean)
- broccoli
- brussels sprouts
- cabbage
- collard greens
- cucumber with peel
- endive
- green scallion
- kale
- lettuce
- mustard greens
- parsley
- spinach
- turnip greens
- watercress
Drug interactions with Coumadin
(Click here for a comprehensive list of drug interactions with coumadin)
1. Increase the INR (make the blood too thin, increase risk for bleeding)
- alcohol
- nonsteroidal antiinfalmmatory agents (such as Motrin, Advil, Aleve)
- aspirin
- Tagamet
- Cipro
- Biaxin
- Doxycycline
- Erthyromycin
- Prilosec
- pencillin
- Dilantin
- propanolol (Inderal)
- quinidine
- Bactrim
- Ticlid
2. Decrease the INR (increase the risk for blood clots)
- alcohol
- Tegretol
- Haldol
- Dilantin
- Carafate
- Vitamin C, K
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