Anti-Platelet and Anticoag Flashcards
Reasons to use cangrelor
Fast on and off
Pt with stent going to surgery
Arctic protocol
Patients NOT loaded with plavix or ticagrelor
Method of action
Bival Rivaroxaban Apixaban Dabigatran - pradaxa UFH LMWH Fondaparinux
DTI Factor X inhib Factor X inhib DTI Factor II Factor II and X Factor X
Reason to use ticagrelor
Low risk patient for bleeding
Must give 81 ASA, not full dose, for continuation
Reason to use plavix
STEMI getting thrombolysis
Trial for bival
ACUITY
Similar outcomes to heparin with less bleeding
Much more expensive however
Trial showing ticagrelor superior to clopidogrel for CV death, MI, CVA after ACS
PLATO
BRUISE CONTROL
Showed that continuing Coumadin is better than stopping and bridging for device surgeries
BRIDGE trial
No benefit to bridging for surgeries, compared to withholding anticoagulation
Symptom duration cutoff for lytics
<3 hr
Clopidogrel dose with lytics
300 if <75 yo
75 if 75 or older
Don’t use prasugrel if:
3
Prior CVA or TIA
Elderly
<60 kg
Avoid gp2b3a when using…
Bival
If no p2y12 given with lytic, can give prasugrel when…
24 hr after lytic
Lovenox prior to PCI protocol
Last dose <8 hr ago, then don’t give more
Last dose 8-12 hr ago, give 0.3 mg/kg IV
For AF, apixaban half dose for what 3 things (2 out of 3)
Age > 80
Wt < 60 kg
Cr > 1.5
