Home Drug Guide Anisindione

Drug Guide

Generic Name

Anisindione

Brand Names Miradon

Classification

Therapeutic: Anticoagulant

Pharmacological: Vitamin K antagonist

FDA Approved Indications

  • Prevention and treatment of thromboembolic disorders, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and atrial fibrillation

Mechanism of Action

Anisindione inhibits the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X, leading to anticoagulation.

Dosage and Administration

Adult: Typically, 2–4 mg orally once daily, adjusted based on INR monitoring.

Pediatric: Use is limited; dosing not well established.

Geriatric: Begin at lower doses due to increased bleeding risk; monitor closely.

Renal Impairment: Use with caution; dose adjustment may be necessary.

Hepatic Impairment: Use with caution; impaired synthesis of clotting factors may alter response.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses placental barrier.

Metabolism: Hepatic metabolism, primarily via conjugation.

Excretion: Metabolites excreted primarily in urine.

Half Life: Approximately 25–60 hours, allowing once-daily dosing.

Contraindications

  • Active bleeding
  • Hemorrhagic disorders
  • Known hypersensitivity

Precautions

  • Pregnancy risk due to teratogenic potential (category X)
  • Use with caution in patients with liver disease, hypertension, or recent surgery

Adverse Reactions - Common

  • Bleeding (Common)

Adverse Reactions - Serious

  • Hemorrhage leading to hypovolemic shock or death (Serious)
  • Hepatic toxicity (Rare)

Drug-Drug Interactions

  • Other anticoagulants, antiplatelet agents, NSAIDs, certain antibiotics

Drug-Food Interactions

  • Foods high in vitamin K (green leafy vegetables) may reduce efficacy

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of bleeding, assess laboratory parameters including INR.

Diagnoses:

  • Risk for bleeding
  • Impaired tissue perfusion

Implementation: Administer as prescribed; monitor INR regularly; educate patient on bleeding precautions.

Evaluation: Maintain therapeutic INR levels; minimize bleeding complications.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of bleeding (e.g., bruising, hematuria, melena).
  • Avoid sudden dietary changes in vitamin K intake.
  • Inform about potential drug and food interactions.

Special Considerations

Black Box Warnings:

  • Risk of severe or fatal bleeding.

Genetic Factors: Genetic variations may affect metabolism and response.

Lab Test Interference: May interfere with certain coagulation tests; INR is the standard monitoring parameter.

Overdose Management

Signs/Symptoms: Excessive bleeding, hematuria, hematomas.

Treatment: Discontinue drug; administer fresh frozen plasma, vitamin K, or prothrombin complex concentrates as needed.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable for prescribed period when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.