A patient is diagnosed with septic shock and is being evaluated for administration of drotrecogin alfa (Xigris). Which of the following factors would absolutely contraindicate administration of the drug to this patient?
a. The patient's INR is 2.
b. The patient experienced a hemorrhagic stroke 1 month ago.
c. The patient has been receiving aspirin (81 mg) daily for the past week.
d. The patient had been receiving warfarin (Coumadin) up until 1 week ago.
ANS: B
Hemorrhagic stroke within the previous 3 months is an absolute contraindication to administration of drotrecogin alfa. Bleeding is the most common and serious side effect of this medication.
Drotrecogin alfa should be used with caution in patients with an international normalized ratio (INR) greater than 3.
Drotrecogin alfa should be used with caution in patients who have taken more than 650 mg of aspirin within the past 7 days.
Drotrecogin alfa should be used with caution in patients who have taken warfarin within the past 7 days.
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