A patient was prescribed heparin sodium 18 units/kg/h; titrate according to the weight-based heparin protocol. The patient's weight is 123 pounds. Heparin 25,000 units/250 mL (100 units/mL) is available. Calculate the flow rate in mL/h (Round to the nearest tenths)

A) Anticoagulants:
Anticoagulants, such as warfarin, heparin, and direct oral anticoagulants (DOACs), are specifically designed to prevent the formation of blood clots or to treat existing clots. They work by interfering with various stages of the clotting cascade, either by inhibiting clotting factors or by enhancing the effects of natural anticoagulants in the body.

B) Antihypertensives:
Antihypertensives, such as ACE inhibitors, beta blockers, and calcium channel blockers, are used to lower high blood pressure by relaxing blood vessels, reducing heart rate, or decreasing fluid retention. While antihypertensives can reduce the overall strain on the heart and blood vessels, they do not have an impact on the clotting process and are not designed to interfere with blood coagulation.

C) Antibiotics:
Antibiotics, such as penicillin or amoxicillin, target bacteria and prevent their growth or kill them, but they do not affect the clotting mechanisms in the blood.

D) Antipyretics:
Antipyretics, such as acetaminophen (Tylenol) or ibuprofen, work by lowering the body's set point temperature in the hypothalamus, helping to relieve fever. They do not affect the clotting cascade or the ability of blood to form clots, so antipyretics are a correct answer.

E) Antiemetics:
Antiemetics, such as ondansetron or metoclopramide, are used to prevent or treat nausea and vomiting. They primarily work by blocking the receptors in the brain that trigger nausea and vomiting but do not have an effect on the clotting process. Thus, antiemetics are a correct answer.

Given:

Ordered dose of Heparin: 15 units/kg/hr

Patient weight: 82 kg

Total Heparin in solution: 25,000 units

Volume of solution: 250 mL

Step 1: Calculate the total dose of Heparin in units/hr:

Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)

Total dose (units/hr) = 15 units/kg/hr x 82 kg

Total dose (units/hr) = 1230 units/hr

Step 2: Calculate the concentration of Heparin in the solution:

Concentration (units/mL) = Total Heparin (units) / Volume of solution (mL)

Concentration (units/mL) = 25,000 units / 250 mL

Concentration (units/mL) = 100 units/mL

Step 3: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Total dose (units/hr) / Concentration (units/mL)

Infusion rate (mL/hr) = 1230 units/hr / 100 units/mL

Infusion rate (mL/hr) = 12.3 mL/hr