Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEX 21 > Anticoagulation > Flashcards

Anticoagulation Flashcards

1
Q

What are anticoagulants commonly used for?

A

ACS
prevention of cardioembolic stroke
prevention/treatent of VTE (DVT/PE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do you use DOACs?

A

when CHADSVASC score >2 in men or >3 women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When would you use warfarin vs DOAC?

A

moderate to severe mitral stenosis or a mechanical heart valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Use DOACs for VTE treatment BUT if the patient has cancer use:

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which anticoagulants bind to antithrombin to indirectly inhibit Xa?

A

UFH equal Xa IIa inhibition
LMWH Xa>IIa
fondapurinox binds to AT to inhibit Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the drug of choice in HIT?

A

injectable argatroban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Binds to AT which then inactivates thrombin (Factor IIA) and factor Xa and prevents the conversion of fibrinogen to fibrin

A

UFH

ok in renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the prophylaxis dose of UFH in VTE presentation?

A

UFH 5000u SC Q8-12H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the treatment dose of UFH in VTE treatment?

A

80u/kg IV bolus; 18u/kg/hr infusion

TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment dose of UFH in ACS/STEMI

A

60u/kg IV bolus, infuse 12u/kg/hr

TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Binds to AT which inactivates factor Xa >factor IIA

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the prophylaxis dose of VTE for enoxaparin?

A

30mg BID or 40mg QD

<30mL/min = 30mg QD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment of VTE and UA/NSTEMI dose of enoxaparin?

A

1mg/kg BID

TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for STEMI of enoxaparin?

A

<75 = 30mg IV bolus + 1mg/kg SC dose

> 75 no bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Brand: Fragmin

A

generic: dalteparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When do you restart warfarin after HIT?

A

when platelets recover to >150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Apixibans dose for nonvalvular Afib/stroke prophylaxis

A

5mg BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Apixibans dose for treatment of DVT/PE

A

10mg PO BID x 7 days

then 5mg PO BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The patient is receiving stroke prophylaxis but the patient >80 and bodyweight is <60kg /Scr >1.5. what’s her apixaban dose?

(only need two of these factors)

A

2.5mg BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which DOAC is reduced efficacy when crcl>95

A

edoxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Brand: Xarelto

A

generic: rivaroxaban

22
Q

Doses >___ of Xarelto require food

A

> 15mg

23
Q

What is the dose of Xarelto for treatment of DVT/PE

A

15mg PO BID x 21 days
then 20mg PO daily

<30ml/min = avoid use

24
Q

if the dose of Xarelto is missed how should it be taken

A

ok to double up to ensure 30mg is taken

*if taking 10, 15, 20mg once daily, immediately on the same day, otherwise skip

25
Q

When do you start edoxaban for the treatment of DVT/PE?

A

60mg daily

start after 5-10 days of IV anticoagulation

26
Q

What is the antidote for apixaban and rivaroxaban?

A

andexanet alfa (Andexxa)

27
Q

Brand: Arixta

A

generic: fondapurinox

28
Q

When a patient has HIT but is going in for a cardiac Cath lab what do you use?

A

bivalrudin (Angiomax)

29
Q

A patient is on an NG tube and is on dabigatran, what do you do?

A

can’t administer, swallow capsules whole!

30
Q

What DOAC has side effects:

dyspepsia, gastritis-like symptoms

A

dabigatran

31
Q

When is the goal for warfarin 2.5-3.5?

A

high risk indications
mechanical mitral valve
or two mechanical heart valves (prosthetic)

32
Q

What are the tablet colors and strength?

A

PLGBBPTYW
Please Let Greg Brown Bring Peaches To Your Wedding

pink-1
lavender-2
green - 2.5
brown/tan-3
blue-4
peach-5
teal-6
yellow-7.5
white-10
33
Q

Foods high in vitamin K?

A 
broccoli
brussel sporouts
cabbage
spinach
tea
34
Q

What drugs increase warfarin?

A

amiodarone
fluconazle
metronidazole
bactrim

35
Q

what drugs decrease warfarin?

A

rifampin

carbamazepine

36
Q

SNRIs, SSRIs, NSAIDs how do they effect warfarin?

A

increase bleeding risk but the INR may not be increased

37
Q

In healthy outpatients, the initial starting dose of warfarin should be

A

10mg daily for the first two days then adjust per INR

38
Q

how do you bridge warfarin?

A

acute DVT/PE

start warfarin on the same day at the IV AC (enoxaparin or UFH), and continue both anticoagulants for a minimum of 5 days until the INR >2 for at LEAST 24 hours

39
Q

1mg of Protamine sulfate will reverse how much heparin?

A

100units

max dose 50mg

1mg per 1mg enoxaparin

40
Q

Brand: Mephyton

A

generic: vitamin K or phytonadione

PO/IV

41
Q

What do you administer with Kcentra?

A

vitamin K

42
Q

INR about therapeutic range but <4.5 without bleeding

A

reduce or skip warfarin dose, monitor INR

43
Q

INR of 4.5-10 without bleeding

A

hold 1-2 doses of warfarin

44
Q

INR >10 without leeding

A

hold warfarin, give PO vitamin K 2.5-5mg even if not bleeding

45
Q

MAJOR bleeding

A

give vitamin K 5-10mg by slow IV and four factor prothrombin complex concentrate (Kcentra)

46
Q

Discontine LMWH how many days before surgery

A

24 hours

47
Q

What are risk factor for DVT?

A 
surgery
major trauma
immobility 
cancer
previous VTE
pregnancy
SER
48
Q

Anticoagulation for patients with AFIB who will undergo cardio version
Afib >48 hours or unknown duration:

A

anticoagulation (if warfarin target INR 2-3) for at least 3 weeks PRIOR to and 4 weeks AFTER cardio version when NSR is restored

49
Q

Anticoagulation for patients with AFIB who will undergo cardio version
Afib <48 hours

A

start full therapeutic anticoagulation at presentation, do cardio version and continue full anticoagulation for at least FOUR weeks while patient is in NSR

50
Q

What is in the CHADSCASC score?

A 
CHF
HTN
age >75 (2 points)
diabetes
prior stroke (2 points)
prior MI, PAD
age 65-74
female
51
Q

What is the AC of choice in pregnancy?

A

LMWH >UFH

*anti Xa levels are recommended to monitor therapy

52
Q

Do you expel the air bubble in the syringe prior to injection?

A

no!

& DO NOT RUB THE SITE OF INJECTION

NAPLEX 21 (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions