Anticoag dosing Flashcards
What weight is used for UFH dosing?
Actual body weight
Dosing UFH for VTE prophylaxis?
SC 5,000 Units SCQ8-12
Dosing for treatment of VTE for UFH?
80 units per kg IV followed by 18 units/kg/hr
Dosing for treatment of ACS or STEMI UFH
60 units/kg IV bolus max 4,000 Units
then 12 units/kg/hour infusion
Tetsing therapeutic levels for UFH? when and what
aPTT or anti Xa
aPPT taken 6 hours after initiation
Take every 6 hours until therapeutic range of 1.5-2.5 x patients baseline
What is the CrCl cut off for lovenox for VTE prophylaxis and hat is the dose?
CrCl<30
30 mg SC daily
VTE prophylaxis dosing for lovenox?
30 mg SC q12h or 40 mg SC daily
Treatment of VTE and UA/NSTEMI for lovenox?
- 1 mg/kg q12h
- or 1.5 mg/kg SC daily only for inpatient VTE treatment
- CrCl<30 mL/min 1mg/kg SC daily
What wt is used for lovenox and UFH?
Actual body wt
Tx of STEMI with Lovenox? <75
30 mg IV bolus plus a 1 mg/kg dose
Stemi Lovenox treatmnet <75 and CrCl <30
Same as normal pt less then 75
30 mg IV bolus plus a 1 mg/kg SC dose
Lovenox STEMI tx pt >75
0.75 mg/kg Q12 no bolus
CrCl< 30 1 mg/kg SC daily no bolus
If a patient has a CrCl< 30 what is the change in dosing usually for lovenox?
Change from q12 to daily
Drugs that increase blood pressure 7
A, C, D, E, I, N, S
- Amphetamines
- Cocaine
- Decongestants
- ESA
- Immunosuppressants
- NSAIDs
- Systemmic steroids
COmbo ACE or ARB + Diuretics 4
- Zestoretic
- Hyzaar
- Divan
- Benicar
ACE or ARB + CCB 2
Lotrel: Benazipril+amlodipine
Exforge: Valsartan/Amlodipine
Direct renin inhibitor + Diuretic 1
Aliskeren/HCTZ Tekturna HCT
Alpha 2 agonist + Diuretic 1
Methyldopa/HCTZ
BB + Diuretic? 2
Tenoretic; Atenolol+Chlorthalidone Tenoretic
Bisoprolol/HCTZ: Ziac
K sparing + thiazide type 1
Triamteren/HCTZ Maxide Dyazide
WHen should pregnant patient be treated with HTN meds?
SBP>= 160
DBP>=105
What are the 3 preferred meds for Pregnant HTN?
Labetalol, nifedipine ER, methyldopa
Microzide
HCTZ
When are thiazides not effective?
CrCl<30
Only thiazide available in IV?
Chlorthalidone
7 SEs of Thiazides
- Hypo Everything, except for calcium and uric acid
- Hypokal
- Hypomag
- Hyponat
- Hypercal
- Increase LDL and TG
- Hyperglycemia
THiazides decrease the clearance of what drug?
Lithium increased toxicity
Most common SEs of non-DHPs
- Fluching
- Reflex tachycardia
- HA
- Peripheral edema
What CCB is the DOC in pregnancy?
ER nifedipine (Adalat and Procardia)
All CCBs both DHPs and Non- can cause what?
Gingival hyperplasia but more so with verapamil
Lotensin
Benazopril
Vasotex and Vasotec IV
Enalaprilat
Altace
Ramipril
MOA of ACE
Block conversion of Ang 1-Ang2
Boxed warning for ACEs
Fetal toxicity
Contraindications to ACEs
Hx of Angioedema
use within 36 hours of neprilysn inhibitor (Sacubirtil/Valsartan)