Heparin vs. Warfarin Practice Questions with Answers and NCLEX® Review

Introduction to Heparin vs Warfarin

Both Heparin and Warfarin are equally effective in preventing blood clots, but they work differently. They specifically work with clients recovering from An MI heart attack or those who are at risk for DVT. Warfarin is an oral medication that requires minimal monitoring, and Heparin is an injectable medication that requires frequent monitoring.

Heparin is an anticoagulant used to treat clients at risk of developing blood clots or post-operatively. It’s also considered an anti-thrombotic and has been used since the 1960s. 

Warfarin (also known as Coumadin) is a drug that helps prevent blood clots from forming in the veins and arteries. It works similarly to Heparin but is given in pill form that can be taken but still requires monitoring via routine blood work.

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Memory trick for labs

• Too high = client will bleed out and die.
• Too low = then clots will grow.

Heparin

Heparin is a blood thinner that works by preventing the formation of clots. It does this by inhibiting the enzyme that makes fibrin (a glycoprotein that’s part of the clotting process).

Heparin can be used to treat clients with DVT, pulmonary embolism, or acute coronary syndrome. It can also be used as a preventive measure in clients post-operatively.

Key Numbers

• Therapeutic Range: 46 – 70 PTT
• Memory trick:
  • “HePTT” the frog
  • Heparin
  • Protamine Sulfate (Antidote)
  • PTT – 46 – 70 Max range
  • Fast onset = Frogs are fast

Warfarin

Warfarin is used to prevent blood clots from forming. It works by reducing the activity of vitamin K, which is essential for producing prothrombin (a protein that helps regulate blood clotting). By decreasing the amount of vitamin K in the body, warfarin makes it harder for clients’ blood to clot.

Warfarin has a weaker start, typically taking five days to reach full effect. 

Key Numbers:

• Therapeutic Range: 2 – 3 INR
• Memory trick:
  • “War-K-IN”
  • Warfarin
  • Vitamin K (Antidote)
  • INR 2 -3 range
  • Slow onset = “Is it even WARkin?”

LMW Heparin

Low molecular weight (LMW) Heparin is a type of anticoagulant that works by inhibiting the final step in the clotting cascade. It is used to prevent blood clots, and is given to clients who are at risk of developing them. 

The mechanism of action of LMW Heparin includes:

• Binding to negatively charged sites on endothelial cells and increasing the amount of time it takes for platelets to bind together and form a clot.
• Inhibiting thrombin from activating fibrinogen, preventing clotting.

Key Numbers

• Platelets should be 150k – 400k
• Hold medication Plt less than 50,000

Heparin vs Warfarin Conclusion

Warfarin and heparin both function well in preventing blood clots. They specialize in helping clients who have had a MI heart attack or are at risk for DVT. 

Heparin is an injectable anticoagulant used to treat clients who have undergone surgery or are at risk of blood clots. Warfarin is an oral drug that helps prevent blood clots from developing in veins and arteries. Although it functions similarly to heparin, there is no need for an IV,  and it can be administered at home (in pill form).

Sources

https://www.ahajournals.org/doi/full/10.1161/hq0701.093686 

https://www.ahajournals.org/doi/10.1161/01.CIR.0000063575.17904.4E 

https://elsevier.health/en-US/preview/low-molecular-weight-heparins