7 ACS Part IV Flashcards
Anticoagulation
recommended in addition to ___ therapy to impprove vessel patency and prevent ___
antiplatelet
re-occlusion
UFH
anti ___ and ___ activity
risk of ___
- drop in ___ count AND increased ___
- caused by formation of ___
- screen tests is suspected: enzyme-linked immunosorbent assay ( ___ ) - quick, high false ___ rate, serotonin release assay ( ___ ) - ___ standard for diagnosis
Xa, IIa
HIT
- platelet, thrombosis
- antibodies
- ELISA, positive, SRA, gold
UFH
- quick onsest and ___ t1/2
- administered as a ___ infusion
- dosing of UFH is based on the ___ or ___
- short
- continuous
- aPTT, ACT
Activated Partial Thromboplastin Time, Activated Clotting Time
Enoxaparin - LMWH
- higher ratio of anti ___ / anti ___ than UFH
- eliminated by ___ (accumulated in ___ impairment)
- Xa/IIa
- kidneys, renal
focus on CrCL for dosing
Bivalirudin
direct ___ inhibitor
- not used together with GPIIb/IIIa inhibitors (except in ___ ___ )
- may not be as effective for MACE and ___ thrombosis
- may have ___ bleeding risk
thrombin
- bail out
- stent
- lower
Fondaparinox
factor ___ inhibitor
not commonly used
- can use in patients with a history of ___
Do not use alone for ___
- high rates of ___
- if already giving fondaparinux and pateint needs PCI, need to give ___ or ___ also
CI for CrCl < ___ mL/min
Xa
- HIT
PCI
- thrombosis
- UFH, bivalirudin
30
Anticoagulation
UFH
Bolus Dose:
- ___ units/kg IV (max 4000 units)
- ___ - ___ units/kg during PCI
Maintenance Dose:
- ___ units/kg/hr infusion titrated to institutional ___ targets
- no maintenance dose during ___
- 60
- 50-100
- 12, aPTT
- PCI
Anticoagulation
enoxaparin
Bolus Dose: ___ mg IV
Maintenance Dose: ___ mg/kg sc q12h (first dose ___ min after bolus)
- if 75 or older, reduce to ___ mg sc q12h
Renal Dosing: CrCl < 30 mL/min
- ___ mg/kg q24h
do NOT hhave to give bolus dose
30
1, 15
0.75
1
Anticoagulation
bivalirudin
Bolus Dose: ___ mg/kg IV
Maintenance Dose: ___ mg/kg/hr infusion
Renal Dosing: CrCl < 30 mL/min
- ___ mg/kg/hr
dialysis
- ___ mg/kg/hr
0.75
1.75
1
0.25
Anticoagulation
Fondaparinux
Bolus Dose: ___ mg IV
Maintenance Dose: ___ mg sc q24h
CI: Renal Dosing: CrCl < ___
- 2.5
- 2.5
- 30
UA/NSTEMI
Ischemia Guided
___ (48 hours)
___ and ___ (duration of hospital stay up to 8 days)
UFH
enoxaparin
fondaparinux
UA/NSTEMI
Early Invasive
___ , ___ , and ___ (all until PCI)
UFH, bivalirudin, enoxaparin
STEMI - fibrinolytic
___ (48 hours)
___ and ___ (duration of hospital stay up to 8 days)
___ (consider using for HIT)
UFH
enoxaparin, fondaparinux
bivalirudin
STEMI - PCI
___ (until PCI)
___ (until PCI, preferred in high bleeding risk)
UFH
bivalirudin
