I am on IV Rocephin flushing with saline and heparin (SASH).
I am about to start Rifampin and I noticed that there is a major drug interaction between Rifampin and Coumadin.
Now I know it's not the same drug - but both are considered blood thinners. Would I be at risk taking Rifampin while on IV?
Should I not be flushing with Heparin while on Rifampin then? ugh - we had a blood scare last week thinking I was bleeding internally so stopped heparin for a bit but all is good and now back on it. I have very small veins so at risk for blood clot so would prefer NOT to stop my heparin flushes!
Posted by penguingirl (Member # 28688) on :
up
Posted by sammy (Member # 13952) on :
You can continue using the heparin flushes.
Heparin and coumadin are both anti-coagulents but they work in different ways. They do not have the same drug interactions.
Posted by penguingirl (Member # 28688) on :
Thanks Sammy!
Posted by Fogged (Member # 32388) on :
Heparin is a very short acting anti-coagulant. Heparin flushes are meant to reduce the chance of clots forming as you say. Coumadin, however, needs to be carefully adjusted over time. Everybody metabolizes it at their own rate, and it can be extremely long lasting if your liver or kidney function is impaired.
When my mom was in the hospital (sorry, just mentioned her on another thread), she had to have chest tubes put in because fluid was building up around her lungs and making it almost impossible to breathe. Well, some bonehead switched her from a heparin drip to Coumadin because that was what she was supposed to be on for her prosthetic heart valve when she went home. She was a long way from going home at that point, but the cardiologist made the switch without consulting the pulmonologist who ordered the tubes to be put in.
Since her kidneys had all but shut down due to all the meds she was on, it took almost two weeks for the Coumadin levels to get low enough for them to perform the surgery. All that time, she had to be kept on a ventilator so she could breathe. When they finally got the tubes put in, they drained off over two gallons of fluid from her pleural cavities. "No wonder the poor girl couldn't breathe", said the pulmomologist.
Well, she never did get to breathe on her own again. All that time being intubated and having a machine do the breathing for her made her lungs so weak she couldn't be successfully weaned off the ventilator. Two days after she was taken off she failed, and they had to do an emergency intubation. They damaged her vocal cords in the process. Eventually, her time on the ventilator was too long, so they had to do a tracheotomy. She died with that damn thing in her throat... speechless to the end.
BTW Coumadin is the same substance as rat poison - Warfarin.
Posted by penguingirl (Member # 28688) on :
Oh wow - Fogged - I am SO sorry to hear what happened to your mother! so awful!
Posted by Fogged (Member # 32388) on :
Thanks, PG.
Yeah, hospitals aren't the best places to go to get well. Just the nosocomial infection death rate is staggering (yup, that's what finally got my mom, fungal endocarditis from an indwelling catheter).
Anyway, just bringing it up to make a point. Our bodies were designed by millions of years of evolution to stay in balance through widely varying circumstances in the environment. Get them out of whack just a little bit and it could be enough to bring about a whole cascade of unfortunate and hitherto unrelated events that can make us very sick... or even bring about our demise.
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