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CPJE > Anticoag > Flashcards

Anticoag Flashcards

1
Q

What can increase bleed risk when given with anticoagulants?

A

NSAIDs, SSRIs, fish oil, garlic, ginger, ginkgo, ginseng, glucosamine, willow, grapefruit

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2
Q

Heparin route of admin

A

IV or SubQ (NOT IM = hematoma)

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3
Q

Heparin SE

A

increased AST, thrombocytopenia/HIT, bleeding

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4
Q

Heparin antidote

A

Protamine

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5
Q

Enoxaparin dosing

A

generally 1 mg/kg
QD for prevention
BID for treatment
renal dosing: 30 mg qd

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6
Q

Enoxaparin antidote and monitoring

A

Protamine. Maybe monitor antiXa but not always req.

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7
Q

Warfarin full effect in how many days?

A

6 days

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8
Q

VItamin K effect on Warfarin

A

Vit K DECREASES Warfarin

decreases INR

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9
Q

When to avoid Warfarin?

A

HIT patients, with Amiodarone or NSAIDs, CYP2C9 genetic variation or CYP3A4 interactions

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10
Q

Warfarin antidote?

A

Vitamin K

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11
Q

Warfarin INR goals

A

2-3 for normal range

2.5-3.5 for mitral valve pts

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12
Q

Increased Bleed Risk with Warfarin

A

Amiodarone, Zafirlukast, Azoles, Bactrim, Macrolides(zpak), tetracycline, FQs, PCNs, etravirine

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13
Q

Drugs that decrease INR

A

Carbamazepine, Phenytoin, Phenobarb, Rifampin, Aprepitant, St Johns, Primidone, vit K

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14
Q

Black Box for Dabigatran or Bivlirudin

A

Epidural = hematoma = paralysis

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15
Q

Pradaxa generic

A

Dabigatran

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16
Q

What anticoagulant can HIT patients take?

A

IV Argatroban

and Fondaparinux

17
Q

Pradaxa antidote

18
Q

Argatroban antidote

19
Q

Dabigatran notes

A

BID for tx, QD for prevention. Pglycoprotein so avoid w/ carbamaz, rifamp, dexamethasone, St Johns

20
Q

Xarelto generic

A

Rivaroxaban

21
Q

Eliquis generic

22
Q

Savaysa generic

23
Q

Arixtra generic

A

Fondaparinux

24
Q

Fondaparinux antidote and monitoring?

A

No antidote

Monitor platelets and antiXa

25
Q

Anticoag safe in pregnancy?

A

Fondaparinux

26
Q

What is HIT?

A

Unexplained 50% drop in platelets. Treat w/ vit K, D/C all heparins, start Argatroban. Wait for Warfarin until platelets come back up. (use together x 5 days)

27
Q

Antiplatelet therapies

A

(PO only) Plavix, Effient, Brillinta

28
Q

Plavix generic

A

Clopidogrel

29
Q

Effient generic

30
Q

Brillinta generic

A

Ticagrelor (ok to crush, use in NG tube)

31
Q

CYP2C19 Med

A

Clopidogrel - requires this enzyme for activation

32
Q

Fatal SE of Clopidogrel

A

TTP = thrombotic thrombocytopenic purpura

33
Q

When to D/C anticoags vs antiplatelets before procedure

A

24 hrs for anticoag (Xarelto)

5 days for Plavix

34
Q

Downsides to Effient

A

More bleeding that Plavix. Can’t use in > 75 yo
no antidote (same for plavix)
Contra for TIA/past stroke

35
Q

IV Platelet Aggregation Inhibitors

A

Abciximab (Reopro) *irreversible
Eptifibatide (Integrilin)
Tirofiban (Aggrastat)

36
Q

Fibrinolytic Notes

A

STEMI only. IV only
*must get within 30 mins of heart attack/hospital arrival
Alteplase, Reteplase, Tenecteplase

CPJE (10 decks)

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