ANTICOAG Flashcards
unfractionated heparin clotting factor activity
Anti-Xa and Anti-IIa
HIT screening tests
ELISA - quick, high false positive
SRA - gold standard, send out lab
which anticoags can cause HIT?
UFH or LMWH
can we give a pt with history of HIT UFH or LMWH?
no
dosing of UFH is based on ____
aPTT
enoxaparin clotting factor activity
Anti-Xa and Anti-IIa
higher ratio of Xa, greater specificity
enoxaparin is ____ eliminated
renally
bivalirudin is a ____
direct thrombin inhibitor
which drug is not used with GPIIb/IIIa except for bail out
bivalirudin
fondaparinux clotting factor activity
Xa inhibitor
which is drug of choice for pts with a history of HIT?
fondaparinux
which drug can we not use alone for PCI?
fondaparinux, need to give bivalirudin or UFH as well
which drug is contraindicated for CrCl < 30?
fondaparinux
UFH dosing
Bolus: 60 units/kg
During PCI bolus: 50-100 units/kg
Maintenance: 12 units/kg/hr infusion titrated to aPTT
enoxaparin dosing
Bolus: 30 mg IV
Maintenance: 1 mg/kg subq q12h
>75: 0.75 mg sc q12
CrCl < 30: 1mg/kg/24h
bivalirudin dosing
Bolus: 0.75 mg/kg IV
Maintenance: 1.75 mg/kg/hr
CrCl <30: 1 mg/kg/hr
dialysis: 0.25 mg/kg/hr
fondaparinux dosing
Bolus: 2.5 mg IV
Maintenance: 2.5 mg sc q24h
CrCl < 30: CONTRAINDICATED
which drug does not need bolus?
enoxaparin
which drugs are maintenance sq?
enoxaparin and fondaparinux
UFH tx
ischemia guided (48 hours)
early invasive (until PCI)
fibrinolytic (until PCI)
PCI
bivalirudin tx
early invasive (until PCI)
PCI (pref if high bleed risk)
enoxaparin tx
ischemia guided (hospital stay 8)
early invasive (until PCI)
fibrinolytic (hospital stay 8)
fondaparinux tx
ischemia guided (hospital stay 8)
early invasive (NOT ALONE)
fibrinolytic (hospital stay 8)
