ANTICOAG

Question 1

unfractionated heparin clotting factor activity

Answer 1

Anti-Xa and Anti-IIa

Question 2

HIT screening tests

Answer 2

ELISA - quick, high false positive
SRA - gold standard, send out lab

Question 3

which anticoags can cause HIT?

Answer 3

UFH or LMWH

Question 4

can we give a pt with history of HIT UFH or LMWH?

Answer 4

no

Question 5

dosing of UFH is based on ____

Answer 5

aPTT

Question 6

enoxaparin clotting factor activity

Answer 6

Anti-Xa and Anti-IIa
higher ratio of Xa, greater specificity

Question 7

enoxaparin is ____ eliminated

Answer 7

renally

Question 8

bivalirudin is a ____

Answer 8

direct thrombin inhibitor

Question 9

which drug is not used with GPIIb/IIIa except for bail out

Answer 9

bivalirudin

Question 10

fondaparinux clotting factor activity

Answer 10

Xa inhibitor

Question 11

which is drug of choice for pts with a history of HIT?

Answer 11

fondaparinux

Question 12

which drug can we not use alone for PCI?

Answer 12

fondaparinux, need to give bivalirudin or UFH as well

Question 13

which drug is contraindicated for CrCl < 30?

Answer 13

fondaparinux

Question 14

UFH dosing

Answer 14

Bolus: 60 units/kg
During PCI bolus: 50-100 units/kg
Maintenance: 12 units/kg/hr infusion titrated to aPTT

Question 15

enoxaparin dosing

Answer 15

Bolus: 30 mg IV
Maintenance: 1 mg/kg subq q12h
>75: 0.75 mg sc q12
CrCl < 30: 1mg/kg/24h

Question 16

bivalirudin dosing

Answer 16

Bolus: 0.75 mg/kg IV
Maintenance: 1.75 mg/kg/hr
CrCl <30: 1 mg/kg/hr
dialysis: 0.25 mg/kg/hr

Question 17

fondaparinux dosing

Answer 17

Bolus: 2.5 mg IV
Maintenance: 2.5 mg sc q24h
CrCl < 30: CONTRAINDICATED

Question 18

which drug does not need bolus?

Answer 18

enoxaparin

Question 19

which drugs are maintenance sq?

Answer 19

enoxaparin and fondaparinux

Question 20

UFH tx

Answer 20

ischemia guided (48 hours)
early invasive (until PCI)
fibrinolytic (until PCI)
PCI

Question 21

bivalirudin tx

Answer 21

early invasive (until PCI)
PCI (pref if high bleed risk)

Question 22

enoxaparin tx

Answer 22

ischemia guided (hospital stay 8)
early invasive (until PCI)
fibrinolytic (hospital stay 8)

Question 23

fondaparinux tx

Answer 23

ischemia guided (hospital stay 8)
early invasive (NOT ALONE)
fibrinolytic (hospital stay 8)