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Neuromuscular I - PnT - CVA/Muscular Spasms > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

What are the names of some common oral anticoagulants?

A

Warfarin (Coumadin; Jantoven)
Dabigatran (Pradaxa)
Rivaroxaban (Xarelto)
Apixaban (Eliquis)

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2
Q

What are the names of some common injectable anticoagulants?

A

Enoxaparin (Lovenox)
Fondaparinux (Arixtra)
Dalteparin (Fragmin)
Heparin

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3
Q

What is the starting dose of Warfarin (Coumadin; Jantoven)?

A

5mg/day

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4
Q

Adverse effects of Warfarin (Coumadin; Jantoven):

A

Skin necrosis
“Purple toe” syndrome
Hemorrhage

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5
Q

Drug interactions of Warfarin (Coumadin; Jantoven):

A 
Amiodarine
Bactrim
Protease inhibitors
Phenytoin
Barbiturates 
Fluconazole 
Oral contraceptives 
*NSAIDs also have a synergistic effect with Coumadin*
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6
Q

Special considerations for Warfarin (Coumadin; Jantoven):

A

Requires therapeutic monitoring
Dietary vit K intake must be consistent
Beverages that increase the risk of bleeding: alcohol; cranberry juice

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7
Q

Why should vitamin K intake be kept consistent when on Warfarin?

A

Changes in diet can affect its efficacy

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8
Q

What are some examples of foods with vitamin K that should be either avoided or kept consistent in the diet if taking Warfarin?

A 
Spinach
Green tea
Asparagus
Kale
Brussels sprouts
Collard greens
Broccoli 
Cabbage
Okra
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9
Q

Warfarin laboratory monitoring –> INR therapeutic range:

A

2.0-3.0

Mitral valve replacement: 2.5-3.5

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10
Q

Once stable, how often should INR be monitored when a patient is on Warfarin?

A

Up to every 12 weeks

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11
Q

What is the antithesis of Dabigatran (Pradaxa)?

A

A vitamin K supplement to stop bleeding

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12
Q

What is a disadvantage of Dabigatran (Pradaxa)?

A

Fewer reversal agents

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13
Q

Indication for Dabigatran (Pradaxa)?

A

ONLY for non-valvular a-fib

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14
Q

Dabigatran (Pradaxa) - dose:

A

150mg 2x/day

75mg 2x/day of renal impairment

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15
Q

Side effects - Dabigatran (Pradaxa):

A

Stomach bleeding

Increased bleeding

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16
Q

Is therapeutic monitoring required when a patient is taking Dabigatran (Pradaxa)?

A

No - patients do not need to get their levels checked as often

17
Q

How are drug interactions for Dabigatran (Pradaxa) compared to Warfarin?

A

Fewer

18
Q

Dabigatran (Pradaxa) - special considerations:

A

New antidote: idarucizumab

No dietary considerations

19
Q

What is Rivaroxaban (Xarelto) used for?

A

Non-valvular a-fib, used in patients who can not take Warfarin or Dabigatran

20
Q

What is Apixaban (Eliquis) used for?

A

Non-valvular a-fib

21
Q

What are pros of new oral anticoagulants?

A

Do not require routine monitoring

Do not have dietary considerations like Warfarin

22
Q

What are cons of new oral anticoagulants?

A

Lack of clinical experience
Expensive
Many do not have antidote/reversal agents to stop bleeding

Neuromuscular I - PnT - CVA/Muscular Spasms (7 decks)

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