Anticoagulant Reversal Flashcards

1
Q

How is warfarin reversed?

A

Vitamin K 10mg over 10 minutes
ICH: Kcentra 2500 units
Other bleed: Kcentra 1500 units
Check INR in 30 minutes and give additional PCC if >1.5

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2
Q

How is Eliquis and Xarelto reversed?

A

Kcentra 50 units/kg with max of 5,000 units

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3
Q

How is pradaxa reversed?

A

Praxbind 5 grams (2 vials)

If not available, use PCC

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4
Q

What additional medication should be considered when reversing an anticoagulant during an acute bleed?

A

TXA

1g over 15 minutes

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5
Q

When are platelets indicated in reversing a bleed?

A

Usually only if <50,000

May consider if <100,000 in ICH

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6
Q

In general, how long from last dose is the anticoagulant effect of NOAC’s thought to be gone?

A

About 3 days for most

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7
Q

How are PT/PTT used to determine the anticoagulant status of DOAC’s and the need for reversal in a bleed?

A

PT/PTT have no role in determining if DOACs are therapeutic or not and do not play a role in deciding whether or not to reverse in an acute bleed

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8
Q

What medication is given to reverse heparin or lovenox?

A

Protamine

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9
Q

How should minor bleeding on warfarin be managed?

A

Hold warfarin, give 2.5-5mg Vit. K orally

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10
Q

What is the onset of action for IV vitamin K in reversal?

A

4-12 hours

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