As an LNC, you are aware of the dangers of anticoagulation with Heparin, Coumadin, Lovenox, and others. These drugs have a very narrow window of safety.
Even in the best of circumstances, when everyone does everything right, anticoagulation can lead to significant toxicity and bleeding, permanent injury, paralysis, blindness, and death.
Safe use requires understanding how they work (mechanism of interaction, onset and duration of action), using antidotes, and recognizing and avoiding drug interactions.
The standard of care requires thorough and careful ordering, compounding, labeling, distribution, administration, and monitoring by healthcare workers. Here is where liability may result:
- If prescribers do not order enough anticoagulation, the patient does not receive the full effects and is at increased risk for blood clots or stroke.
- Medication errors by nurses and pharmacists may lead to therapeutic failure or life threatening bleeding episodes due to anticoagulant toxicity.
- Also, healthcare providers may lack understanding about drug interaction risks, and the use and interpretation of laboratory tests monitoring for safety and efficacy of anticoagulants.
- Healthcare providers have an obligation to educate patients about the complexities of the anticoagulation regimen to avoid under or overutilization of the medications.
Dr. James T. O’Donnell has 20 years of experience as a clinical pharmacist in acute care hospitals. He has been responsible for establishing and maintaining safe medication distribution and control systems. An experienced expert witness, Dr. O’Donnell will share lessons from the courtroom involving cases of injuries associated with misuse of anticoagulants.
When you go through this online training you will be able to:
- List the common anticoagulants in clinical use; describe their mechanism of action, onset and duration of antidotes, treatment for overdose
- Identify common reference material for clinical monitoring, the types of laboratory tests measured when treating patients with anticoagulants
- Describe common medication errors by nurses and pharmacists leading to anticoagulant toxicity
- Recognize common drug interactions enhancing or diminishing anticoagulant effect, leading to bleeding injuries or lack of effect (risk of clots)
- Determine which anticoagulants are commonly used together
Dr. James O’Donnell is a Professor of Pharmacology and frequent consultant in litigation in cases in which patients have suffered injury and/or death due to misuse of anticoagulants, as a result of inappropriate prescribing, inadequate monitoring, faulty compounding and labeling, and poor patient compliance. He has worked on high-profile cases in the national news. He is responsible for medical college instruction on adverse drug reactions and drug interactions and is the editor of several “Drug Injury” books and more than 200 publications addressing drug injury.
Dr. James O’Donnell earned his Bachelor’s and Doctorate degrees in Pharmacy from the Universities of Illinois and Michigan respectively, and earned a Master’s degree in Clinical Nutrition from the Rush University. He is currently an Associate Professor and Course Director for Medical Pharmacology at the Rush University Medical Center. Dr. O’Donnell is also a Lecturer in the Department of Medicine at the University of Illinois College of Medicine. He is a Diplomate of the American Board of Clinical Pharmacology, a Fellow of the American College of Clinical Pharmacology, a Diplomate of the Board of Nutritional Specialties, and a Fellow in the American College of Nutrition, and member of several professional societies. In addition to his academic and editorial endeavors, he regularly consults in drug and pharmaceutical matters to industry, government, and law.
Moderator: Pat Iyer MSN RN LNCC
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