Anticoag Special Population

Question 1

Anti Coag elimination pictures

Answer 1

Question 2

Dalteparin for CrCL < 30

Answer 2

DO NOT USE

Question 3

Enoxaparin for CrCL 20-30 and <20

Answer 3

Real life you switch to heparin but you can do .7mg/kg daily

Question 4

Bivalirudin CrCL 30-60, 10-29 or CVVHD, IHD

Answer 4

30-60 -.08 mg/kg/hr
.05 mg/kg/hr
.04 mg/kg/hr

Question 5

Fondaparinux CrCL <30

Answer 5

AVOID

Question 6

VTE CKD for DOAC

Answer 6

Dabigatran DO NOT USE
Rivaroxaban DO NOT USE
Apixaban no adjustment
Edoxaban 30 mg for 15-50, ≤60 on PgP, CrCL <15 do not use

Question 7

What anticoagulant can we use in pregnancy

Answer 7

LMWH and UFH
Will usually use Endoxaparin

Question 8

What testing do i chose to monitor levels with a pt with anti phospholipid symdome

Answer 8

Use anti Xa

Question 9

When do we think thrombophilias may be present

Answer 9

Family history
VTE before 40
A lot of miscarries for pregnant people

Question 10

For thrombophilias Carrier what 2 situation can we adjust med and what is the guideline

Answer 10

Pregnancy with fetal loss
Antepartum - AT3 deficiency use UFH or LMWH
Post partum - AT3, Protein C or Protein S - give prophylaxis of SQ UFH or LMWH or warfarin for 6 months

Question 11

When are you using anticoagulant for life

Answer 11

2 or more spontaneous episodes of VTE