32. Anticoagulation

Question 1

Types of Anticoagulants

Answer 1

1. Heparin
   - Unfractionated Heparin (UFH)
   - Low Molecular Weight Heparin (LMWH)
2. Factor Xa Inhibitor
3. Direct Thrombin Inhibitors
4. Vitamin-K dependent Factor - warfarin

Question 2

Low Molecular Weight Heparin (LMWH)

Answer 2

1. Enoxaparin (Lovenox)

2. Dalteparin (Fragmin)

Question 3

Enoxaparin

Answer 3

Lovenox

Question 4

Dalteparin

Answer 4

Fragmin

Question 5

Oral Direct Factor Xa Inhibitors

Answer 5

Apixaban (Elliquis)
Rivaroxaban (Xarelto)
Edoxaban (Savaysa)
Betrixaban (Bevyxxa)

Question 6

Apixaban

Answer 6

Elliquis

Question 7

Rivaroxaban

Answer 7

Xarelto

Question 8

Injectable Indirect Factor Xa Inhibitors

Answer 8

Fondaparinux (Arixtra)

Question 9

Fondaparinux

Answer 9

Arixtra

Question 10

Oral Direct Thrombin Inhibitors

Answer 10

Dabigatran (Pradaxa)

Question 11

Dabigatran

Answer 11

Pradaxa

Question 12

Injectable Direct Thrombin Inhibitors

IV, SC

Answer 12

Argatroban
Bivalirudin (Angiomax)
Desirudin (Iprivask)

Question 13

Bivalirudin

Answer 13

Angiomax

Question 14

Desirudin

Answer 14

Iprivask

Question 15

Warfarin

Answer 15

Coumadin

Jantoven

Question 16

Heparin Antidote

Answer 16

Protamine

Question 17

Antidote for Apixaban and Rivaroxaban

Answer 17

Andexanet (Andexxa)

Question 18

Antidote for Dabigatran

Answer 18

Idarucizumab (Praxbind)

Question 19

Antidote for Injectable Direct Thrombin Inhibitors

Answer 19

NO antidote

Question 20

Andexanet

Answer 20

Andexxa

Question 21

Idarucizumab

Answer 21

Praxbind

Question 22

Antidote for Warfarin

Answer 22

Vitamin K

Question 23

Monitoring parameter for Anticogulation

Answer 23

1. aPTT/PTT - UFH
2. Usually NOT but anti-Xa factor level - LMWH
3. PT/INR - warfarin

Question 24

UFH dosing, VTE prophylaxis

Answer 24

5,000 units SC Q8-12 H

Question 25

UFH dosing, VTE treatment

Answer 25

Bolus: 80 units/kg. MAX: 5,000 units

Continuous Infusion: 18 units/kg/hr. MAX: 1,000 units/hr

Question 26

UFH dosing, ACS/STEMI treatment

Answer 26

Bolus: 60 units/kg. MAX: 4,000 units

Continuous infusion: 12 units/kg/hr. MAX: 1,000 units/hr

Question 27

LMWH dosing, VTE treatment

Answer 27

30 mg SC Q12H OR 40 mg SC daily

If CrCl <30 ml/min: 30mg SC QD

Question 28

LMWH dosing, VTE/UA/NSTEMI treatment

Answer 28

1 mg/kg/ SC Q12H or 1.5 mg/kg/SC QD (inpatient

If CrCl < 30 ml/min: 1mg/kg SC QD

Question 29

LMWH dosing, STEMI treatment, < 75 yo

Answer 29

Bolus: 30 mg IV + 1mg/kg SC
Followed by: 1mg/kg SC Q12H (MAX: 100 mg for the first 2 SC doses only)

If CrCl< 30 ml/min then
Bolus: 30 mg IV + 1mg/kg SC
Followed by 1 mg/kg/SC QD

Question 30

LMWH dosing, STEMI treatment, 75 yo and above

Answer 30

NO bolus
0.75 mg/kg SC Q12H (MAX: 75 mg for the first 2 SC doses ONLY)

If CrCl < 30 ml/min: 1mg/kg SC QD