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Qs > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

Wafarin INR > 8

A

Minor bleeding: IV
No bleeding: PO 2.5mg

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2
Q

Wafarin INR 5-8

A

Bleeding: IV
No bleeding: withold 1-2 doses

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3
Q

Warfarin: SE

A
  • Painful rash
  • Haemorrhage, prolonged bleeding
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4
Q

Warfarin: administration

A

OD evening
empty

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5
Q

Abx which decrease anticoagulant effect of warfarin

A

Rifampicin

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6
Q

Abx which increase anticoagulant effect of warfarin

A

C
D
E
M

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7
Q

Switching warfarin to dabigatran

A

o Yes in diabetes
o No in GI ulcer, prosthetic heart valve, recent surgery, malignant neoplasm

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8
Q

Which DOACs have reversible agents?

A

DAR

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9
Q

When is apixaban 2.5mg bd indicated?

A

Creatinine clearance is 15-29mL/min
or the following TWO apply from:
1) 80 +
2) 60kg or less
3) serum creatinine 133 micromol/L or over.

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10
Q

Apixaban: renal

A

CI < 15

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11
Q

Edoxoban: SPAF

A

< 60kg = 30mg OD
> 60kg = 60mg OD

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12
Q

How long before surgery should you discontinue edoxaban?

A

24h

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13
Q

Edoxaban: renal

A

Avoid < 15

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14
Q

Edoxaban and ketonazole max dose

A

30mg OD

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15
Q

Rivaroxaban: ACS

A

2.5mg BD

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16
Q

What is the dose for rivaroxaban in patients with DVT/PE?

A

15mg BD (twice daily) for 21 DAYS then 20mg OD (once daily)

17
Q

Rivaroxaban: administration

A

Swallow whole (can crush)
15 + 20mg must be with food otherwise absorption is decreased

18
Q

Rivaroxaban: renal

A

Avoid < 15

19
Q

Dabigatran: administration

A

Cannot be crushed
Whereas other DOACs and VKA can

20
Q

Dabigatran + amiodarone and verapamil

A

Decrease the dose
Administer the drugs at the same time

21
Q

What autoimmune disease should DOACs be avoided in

A

Antiphospholipid syndrome
Use VKA instead

22
Q

Dabigatran: renal

A

Avoid < 30

23
Q

Which DOAC is least likely to be chosen with renal impairment?

A

Dabigatran

24
Q

How many days prior to elective surgery should ticagrelor be stopped?

A

5

25
Q

How many days should you STOP clopidogrel prior to elective surgery?

A

7

Qs (27 decks)

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