Some patients report increased postprandial pain after eating large or fatty meals. Therefore, the diet should be appropriately altered to small, multiple meals or low-fat meals. Because protein C and S are the first factors to be inhibited, there is a prothrombic effect during initial few days after instituting warfarin. Start patients on heparin first, and then switch to warfarin when the PT, PTT, and INR are therapeutic. Duration of action is 2-5 d.
Anticoagulant effect is related to ability to activate plasma antithrombin.
Main role of heparin in these patients is to prevent thrombus propagation. Vasodilator - Used during arteriogram to decrease vasospasm in occluded arteries, with the objective of improving blood flow. Postoperative care Ambulate early due to a high incidence of postoperative ileus. Monitor blood pressure to prevent hypotension, which can induce ischemia. Routine visceral duplex ultrasound is recommended every 4-6 months.