A-fib, Warfarin therapy Flashcards

1
Q

___ is the most common arrythmia

A

A-fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If not tx, A-fib can l/d:

A

thromboembolic event (stroke), worsened CHF, reduced exercise tolerance, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Goal of A-fib tx:

A

block AV node, restore NSR, prevent thromboembolism, improve exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A-fib medications include:

A

digoxin, BB, CCB, antiarrythmics (amiodarone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Digoxin has ___ onset, whereas CCB’s and BB’s have a ___ onset.

A

slow, rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

___ have effect of bradycardia and impotence, so must educate.

A

BB’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risks of anticoagulants include:

Benefits of anticoagulants include:

A

bleeding, hemorrhagic stroke

preventing ischemic stroke and embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CHADS in deciding whether to start on anticoagulant therapy includes:

A
CHF
HTN
Age > 75 yrs
Diabetes
Stroke/TIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Warfarin works to deplete ___ in the body, which is responsible for clotting factors inside the body. Therefore, it is known as a vitamin K ___.

A

vitamin K, antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Warfarin has a ___ therapeutic index

A

narrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Takes ___-___ days for warfarin to reach maximum effect. So start pt on warfarin, wait ___-___ days and recheck ___/___.

A

3-5, 3-5, PT/INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Do we give loading doses of warfarin?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

These clotting factors need to be cleared from the system in order for warfarin to have its full effect:

A

Protein C, Protein S, II, VII, IX, and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adverse effects of warfarin include:

A

bleeding, skin necrosis, purple toes syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Warfarin is contraindicated in ___ bc it is category X, ___, ___, and high ___ risk.

A

pregnancy, senility, alcoholism, bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Must monitor ___ while on warfarin therapy. Normal range is ___-___ for normal pts and ___-___ for mechanical valve pts.

A

INR, 2.0-3.0, 2.5-3.5

17
Q

What is the initial dose of warfarin therapy?

A

start on 5 mg

18
Q

What is the antidote for warfarin? Give if pt has elevated INR.

A

Vitamin K

19
Q

Monitor INR ___ weekly until you have ___ consecutive INR’s in range, then monitor every ___ weeks as stable.

A

twice, 2, 4

20
Q

Instruct pt to call if black tarry stools, excessive bruising, hematuria while on ___.

A

warfarin

21
Q

Educate pt not to take any ___ or ___ while on warfarin. Educate to be consistent w/vit K foods.

A

OTC’s, herbs

22
Q

The antiarrhythmic medication, ___ increases INR while on warfarin, so pt’s on this med must reduce warfarin in half.

A

amiodarone

23
Q

OTC’s like ASA and NSAIDS ___ warfarin effects. Chronic alcoholism will ___ INR. Foods high in Vitamin K will ___ INR. Herbals may ___ INR.

A

increase, decrease, decrease, increase

24
Q

Increase warfarin weekly dose by ___-___% for 2 days a week. Try to use one tablet strength, so pt is not confused.

A

5-20

25
Q

Write down on calendar to take 5 mg on ___, ___, and ___. Take 7.5mg on ___ and ___.

A

mondays, wednesdays, fridays, tuesdays, thursdays.

26
Q

___ is a new anticoagulant that does not require any lab monitoring.

A

Pradaxa