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The Clinic is a service established to monitor and manage the medications that you take to prevent blood clots. Nurses and Advanced Practice Clinicians, in conjunction with your physician, will work together to ensure these medications are used safely. For patients taking Warfarin (Coumadin), we will routinely check blood work and adjust your dose of Warfarin (Coumadin) as well as other medicines that may be needed.
Anticoagulants may be administered to patients after mechanical valve replacement surgery, diagnosis of clotting disorder, stroke, deep vein thrombosis, pulmonary embolism, and atrial fibrillation. For patients taking Coumadin, a regular blood test, called an INR (International Normalized Ratio), is done to determine whether you’re getting the right amount of Coumadin. For alternative anticoagulants such as Eliquis, Pradaxa, Savaysa or Xarelto, INR testing is not necessary.
Medications used to thin the blood can be dangerous if not closely monitored. Specifically with Coumadin, your blood clotting time or INR must be checked. When Coumadin therapy is initiated your labs will need to be checked on a weekly basis while we work to get your levels in the proper range. Once your levels are stabilized, we will likely check blood work every 4-5 weeks. However, you may be checked more often when changes are made to other medications or if INR results are not within the designated therapeutic range. For alternative anticoagulants such as Eliquis, Pradaxa, Savaysa or Xarelto, labs are checked every six months.
Patients generally begin treatment after surgery or diagnosis. After your physician sends in the referral form, you will be contacted by the Anticoagulation Clinic to discuss your therapy and to arrange your first appointment. At your initial visit you will be given thorough education about your medication. For patients starting Coumadin therapy, a nurse will check your INR by using a finger stick blood test (the result will be available immediately). You will be asked some questions about your health and medications, determine if your warfarin dose should be adjusted, and schedule your next appointment. Patients are assessed by the nurses in the Anticoagulation clinic at least once a month after the initiation of Coumadin therapy. Future frequency of visits is determined by stability of the INR. All patients on any anticoagulant therapy will be evaluated in the office every six months.
The Anticoagulation Clinic will provide patient education which includes the purpose of the patients therapy, duration of therapy, dosing and administration of prescription(s), what to do if you miss a dose, compliance, monitoring, signs and symptoms to watch for (bleeding and clotting), drug interactions, preferred nutritional diet as well as alcohol intake, informing the patients other healthcare providers, follow-up appointment information, medical alert bracelet or card.
