AC: Reversal Agents Flashcards

1
Q

Protamine

A

Heparin Reversal

1 mg protamine : 100 units circulating heparin

Max 50 mg in 10-min period

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2
Q

Protamine for LMWH

A

– 1 mg protamine : 1 mg enoxaparin (if enox. given < 8 hours ago)
– 0.5 mg protamine : 1 mg enoxaparin (if enox. given > 8 hours ago)

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3
Q

Protamine AEs

A

– Dyspnea, wheezing, cyanosis
– Flushing, urticaria
– Chills
– Chest pain
– Nausea / vomiting
– Bradycardia, severe hypotension, anaphylactoid reactions have occurred from too rapid admin

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4
Q

Vitamin K

A

Warfarin Reversal

PO preferred, IV for life-threatening bleeds

  1. hold warfarin therapy
  2. give one dose of Kcentra
    -INR 2-3.9: 25
    -INR 4-6: 35
    -INR > 6: 50
  3. give IV Vitamin K 5-10 mg/50 mL NS, IV over 30 minutes
    * Vitamin K can be repeated every 12 hours*
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5
Q

Idarucizumab (Praxbind)

A

Only for dabigatran reversal

2.5g/50mL IV bolus x2 (total dose=5g)

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6
Q

Andexanet Alfa (AndexXa)

A

Only for rivaroxaban or apixaban

Low dose: R<10, A<5 (>8hr, <18hr)
-400 mg at 30 mg/min then 480 mg IV/2hr

High dose: opp
-800 mg at 30 mg/min then 960 mg IV/2hr

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7
Q

Fresh Frozen Plasma (FFP)

A

10-20 mL/kg will increase factor levels by 20-30%

1-unit FFP = 200 mL

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