A
nti-Coagulation: Preventing Blood Clots
After Hip or Knee Surgery
University of
Pittsburgh
Medical Center
Information
for Patients
After hip or knee surgery, blood clots sometimes form. Your doctor has prescribed medicine
to prevent blood clots. This medicine is called
a blood thinner. Another name is anti-coagulant
(AN-tee-co-AG-you-lent).
It is very important that you keep all your
appointments for blood tests and follow-up
visits with your doctor. Your doctor will decide
how long you need to take your blood thinner.
Along with the blood thinner, your doctor may
prescribe other methods to prevent blood clots.
These may include wearing support stockings,
doing ankle pumping exercises, getting out of
bed the day after surgery, and going to physical
therapy. Any or all of these may help to prevent
blood clots.
If you miss a dose
Some common blood thinners are Coumadin,
Lovenox, Fragmin, heparin, and aspirin and
aspirin products (such as Ascriptin, Ecotrin, and
enteric-coated aspirin). Your doctor will choose
the medicine he or she feels is best for you.
Taking your medicine
It is very important to follow the instructions
for your blood thinner. You should take your
medicine at the same times every day. Some
of these medicines are taken by mouth and
some by injection (shots). If you must take
your blood thinner in a shot, you or a family
member will receive special training to learn
how to give shots.
Follow the guidelines below if you miss a dose
of your medicine.
Coumadin
If you miss a dose of Coumadin, take the
missed dose as soon as possible on the same
day. Do not take a double dose the next day
to make up a missed dose.
Lovenox
Call your doctor if you miss a dose of
Lovenox.
Fragmin
If you miss a dose of Fragmin, take your usual
dose as soon as you remember. If you don’t
remember until the next day, do not take a
double dose. Take your usual dose, and call
your doctor.
If your doctor orders Coumadin for you, you
will have to have blood tests to see if your
dosage needs to be adjusted. If your medicine
needs to be adjusted, your doctor will call you
and tell you the new dosage to take.
continued
University of
Pittsburgh
Medical Center
Information
for Patients
Precautions
• vomiting or coughing up blood
You will be able to do most of your normal
activities while taking this medicine. You
need to follow some precautions:
• increased bruising
• Use an electric shaver instead of a blade
razor when you shave.
• Do not engage in contact sports.
• Tell all your doctors and dentists at all
your appointments that you are taking a
blood thinner.
• Do not take any aspirin or aspirin products
unless you check with your doctor.
• Do not take any new medicines until you
check with your doctor. This includes
over-the-counter medicines, herbal products,
vitamins, and supplements.
• Do not drink alcohol while taking blood
thinners.
• Do not take blood thinners if you are
pregnant or become pregnant. Check with
your doctor first.
• Think about getting a medical alert bracelet that says you are taking a blood thinner.
• Think about carrying a card in your purse
or wallet that says you are taking a blood
thinner. Carry the card only while you take
the medicine.
• falling and hitting your head
• pain, swelling, redness, or warmth in
your legs
• shortness of breath
• chest pain or rapid heart beat
• feeling faint or weak
Watch your diet
You take Coumadin to lower your blood’s
ability to clot. Vitamin K increases your blood’s
ability to clot. If the amount of vitamin K in
your diet changes, Coumadin may not work
the way it should. While you are taking
Coumadin, you must be aware of foods high
in vitamin K. Keep the amount of vitamin K
in your diet the same every day.
Foods high in vitamin K
Beverages:
herbal teas containing tonka beans, melilot
(sweet clover), or woodruff
green teas
Fats:
mayonnaise
When to call the doctor
Oils:
If you have any of the following, call your
doctor or nurse:
soybean oil and canola oil
• bleeding gums
broccoli, brussels sprouts, cabbage, cauliflower, collard greens, cucumber peel, endive,
green beans, green peas, green scallions, kale,
lettuce, mustard greens, parsley, spinach, and
turnip greens
• nose bleeds
• blood in your urine or stool
• black, tarry stools
Vegetables:
How to give yourself shots
If you take Fragmin
If your doctor prescribes Fragmin or Lovenox
for you, you must receive this medicine in a
shot. Below is a step-by-step guide to give
yourself shots.
Possible shot sites
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3. Clean the site well with an alcohol pad or a
cotton ball soaked in alcohol.
4. Remove the cap from the Fragmin or
Lovenox syringe. Pull the cap straight off
to keep the needle from bending.
5. The syringe may contain more than the
amount of medicine prescribed. If so, push
the plunger until the correct amount of
medicine remains in the syringe. If you are
taking Lovenox, do not expel the small air
bubble inside the syringe. The bubble helps
push the medicine through the syringe.
6. You must give your shot in the fatty tissue
under your skin. Pinch together a fold of
skin with the thumb and fingers of one hand.
7. With your other hand, insert the needle of
the syringe into the fold of skin. Slowly
push the plunger into the syringe until all
the medicine is out of the syringe.
8. Pull the needle out of your abdomen or
thigh. Throw away the syringe at once. Put
the syringe in the red sharps container from
your kit. Or put it in a sturdy container the
needle cannot puncture. Store the container
in a safe place away from children.
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1. Wash your hands well.
2. Choose a place on your abdomen or your
thigh for the shot. The place for the shot is
called a site. (If you take Fragmin, see the
diagram on this page. If you take Lovenox,
see the diagram on Page 4.) Avoid the areas
near your incision if you’ve had hip surgery.
Use a different site every day.
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Daily log
You may find it helpful to keep track of the
sites you use each day. On the diagram above,
each site has a letter. When you give yourself
a shot at a particular site, find the site letter on
the log below. In the empty space, fill in the
date of the shot.
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9. Do not rub the site after you give the shot.
continued
If you take Lovenox
Possible shot sites
Leave at least 2 inches between the shot site
and your belly button.
University of
Pittsburgh
Medical Center
Information
for Patients
The University of Pittsburgh Medical Center is
an equal opportunity employer. Policy prohibits
discrimination or harassment on the basis of race,
color, religion, national
origin, ancestry, sex, age,
marital status, familial
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disability, or veteran status. Further, UPMC will
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policy applies to admissions,
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programs and activities.
This commitment is made
by UPMC in accordance
with federal, state, and/or
local laws and regulations.
This information is not
intended to be used as a
substitute for professional
medical advice, diagnosis,
or treatment. You should
not rely entirely on this
information for your health
care needs. Ask your own
doctor or health care provider any specific medical
questions that you have.
Daily log
You may find it helpful to keep track of the
sites you use each day. On the diagram above,
each site has a letter. When you give yourself
a shot at a particular site, find the site letter
on the log below. In the empty space, fill in
the date of the shot.
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Pittsburgh, PA, USA
www.upmc.com
© University of Pittsburgh Medical
Center 2003
SYS210950 ED/JDS REV 03/03
Form # 6078-82190-1202
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