Anticoagulants Pharmacotherapy Flashcards
What is Apixaban, Dabigatran, Edoxaban and Rivaroxaban ALL indicated for?
What is Rivaroxaban exclusively indicated for, and not the other anticoagulant?
What is Apixaban, dabigatran and Rivaroxaban only indicated for?
MAO Of DOACS
In comparison to warfarin what is the risk of intracranial haemorrhage and major bleeding with DOACS?
Bleeding is an important adverse effect, most commonly epistaxis, GI, and genitourinary haemorrhage. The risk of intracranial haemorrhage and major bleeding is less with DOACs than with warfarin.
What are other adverse effects associated with DOACS?
What reversal agent would be given in the case of DOAC overdose?
What are the C/I for DOACs?
What would the hepatic function score have to be that would make you cautious of prescribing a DOAC?
What are important PD drug-drug interactions for ALL DOACS.
What are important PK drug-drug interactions for ALL DOACS.
Baseline testing before starting DOAC?
After starting or changing DOAC dose when should Ptx be reviewed?
Which DOAC cannot be taken out of it’s blister pack?
Dabigatran [ https://www.sps.nhs.uk/home/tools/medicines-in-compliance-aids-stability-tool/]
How should you switch a person from or to another anticoagulant? (switching from warfarin to Edoxaban)
What is the dose for the Prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) Apixaban.
When is dose reduction appropriate in the case of apixaban
The recommended dose of apixaban is 5 mg taken orally twice daily.
Apixaban dose for the prophylaxis of recurrent DVT and PE in adults (following completion of 6 months of anticoagulation treatment):
What is the surgical dose for knee replacement and hip replacement for Apixaban. What are the treatment duration for the respective procedures.
Knee replacement: 2.5 mg BD 10-14 days (12-24 hours after the procedure)
Hip replacement: 2.5 mg BD for 32-38 days (12-24 hours after procedure)
What is the dose for the Prevention of stroke and systemic embolism in patients
with non-valvular atrial fibrillation (NVAF) Rivaroxaban
When is dose reduction appropriate in the case of Rivaroxaban
What is the dose for the Prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) Edoxaban
When is dose reduction appropriate in the case of Edoxaban
What is the dose for the Prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) Dabigatran
When is dose reduction appropriate in the case of Dabigatran
Which DOAC requires a dose reduction if CrCl is 15-49 mL/min?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(C)
Which DOAC requires a dose reduction if CrCl is 15-50 mL/min?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(B)
Which DOAC requires a dose reduction if CrCl is 30-50 mL/min?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
D
Which DOAC requires a dose reduction if CrCl is 15-29 mL/min?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
A
Which DOAC requires dose reduction is patient weighs less than 60 kg?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(a) (b)
Which DOAC can be crushed and mixed with water or apple puree immediately before and followed by food immediately after, ingestion?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(C)
Which DOAC requires dose reduction for patients aged of 80 years OR receiving coconcurrent treatment with verapamil?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(D) Dabigatran due to Verapamil hydrochloride and diltiazem hydrochloride are combined P-glycoprotein (P-gp) and CYP3A4 inhibitors and may be associated with increases in the risk of bleeding with DOACs.
Which DOAC requires dose reduction for patients aged of 75 years.
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(D)
Which DOAC requires close monitoring when Ptx boxy weight is less than 60 kg as prophylaxis of atherothrombotic events following an ACS, or prophylaxis of atherothrombotic events in people with CAD or symptomatic PAD?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(C)Rivaroxaban (no dose adjustment needed)
Which DOAC requires close monitoring when Ptx boxy weight is less than 50 kg ?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(D)
Which DOAC is dose reduction required if P-gp inhibitor is co-administered?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(B)
What is the hepatic function score that would make you be cautious with prescribing DOACs
A. Child Pugh score 2 or 3
B. Child Pugh score of 1
C. ALT/AST x2 times the upper limit of normal
D. Bilirubin over 1.2 times the upper limit of normal
(A) and © [ref: SPS]
Which DOAC has a daily dose of 5mg BD?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(A)
Which DOAC has a daily dose 150 mg BD ?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(D)
Which DOAC has a daily dose 60 mg OD?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(B) Edoxaban
Which DOAC has a daily dose 20 mg OD?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(C)Rivaroxaban
What is the licensing age for DOACs?
+16 above it is licensed for use.
Which DOAC is associated with abnormal hepatic function?
A. Apixaban
B. Edoxaban
C. Rivaroxaban
D. Dabigatran
(D)
When patient is to have minor dental procedure what is the advice for stopping DOACs?
A. Stop at least 36 hours before procedure
B. Stop 48 hours before procedure
C. Stop 72 hours before procedure
D. Stop 24 hours before procedure
(D)
When patient is to have minor dental procedure with reduced renal function what is the advice for stopping DOACs (?
A. Stop at least 36 hours before procedure
B. Stop 48 hours before procedure
C. Stop 72 hours before procedure
D. Stop 24 hours before procedure
A
Which anticoagulant must be taken with food to increase bioavailability?
A. Edoxaban
B. Rivaroxaban
C. Apixaban
D. Dabigatran
(B) Rivaroxaban 15 mg and 20 mg
Which anticoagulant cannot be put in blister pack and why?
A. Edoxaban
B. Rivaroxaban
C. Apixaban
D. Dabigatran
(D) Dabigatran-hygroscopic in nature
