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NAPLEX 2022 > Anticoagulation > Flashcards

Anticoagulation Flashcards

1
Q

What laboratory parameters are monitored during heparin therapy?

A

Hct
Hgb
Plt
aPTT (1.5-2.5)

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2
Q

Lovenox MOA

A

Inhibits factor Xa and factor IIa via antithrombin

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3
Q

Purpose of HepFlush (heparin lock flushes)

A

keep IV lines open

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4
Q

LMWH DDIs

A

NSAIDs, SSRIs, SNRIs

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5
Q

What medications can increase her bleeding risk?

A

Clopidogrel
Metronidazole
SSRIs/SNRIs
5 G’s (garlic, ginger, ginseng, glucosamine, gingko)

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6
Q

What medications can increase the metabolism of warfarin and decrease the INR?

A

Carbamazepine

St. John’s wort

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7
Q

Guidelines recommend that the first, unprovoked VTE be treatment for how long and with what INR goal?

A

At least 3 months with an INR goal of 2-3.

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8
Q

What is the standard dose of apixaban for DVT/PE treatment?

A

10 mg BID x 7 days, then 5 mg BID

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9
Q

What is the standard dose of apixaban in nonvalular AFib (stroke prophylaxis)?

A

5 mg BID

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10
Q

Name the CYP2C9 inhibitors that can increase INR.

A

Amiodarone (decrease dose of warfarin by 39-50%)
Azole antifungals (fluconazole)
Metronidazole
Bactrim

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11
Q

Warfarin MOA

A

competitively inhibits vitamin K epoxide reductase (VKORC1) enzyme complex

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12
Q

Unfractionated heparin MOA

A

binds to antithrombin (AT), which inactivates thrombin (factor IIa) and factor Xa

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13
Q

What are the primary risks of a patient not using anticoagulants or having anticoagulats at subtherapeutic levels?

A

DVT/PE

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14
Q

Warfarin counseling in pregnancy

A

Unsafe in pregnacy and should be avoided (Category X)

*Unless patient has a mechanical heart valve (Category D)

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15
Q

Antidote for the anticoags

A

dabigatran (Pradaxa) - idarucizumab (Praxbind)

warfarin - Vitamin K, phytonadione (Mephyton), 4 factor prothrombin (Kcentra)

UFH/LMWH - protamine

apixaban/rivaroxban - andexanet alfa (Andexxa)

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16
Q

What agents are safe to use in Heparin-induced Thrombocytopenia (HIT)?

A

argatroban

bivalirudin (preferred if urgent cardiac surgery or PCI required)

17
Q

Routes of administration for heparin

A

IV and SC

18
Q

What is the name of the test used to monitor heparin for efficacy?

A

activated partial thromboplastin time (aPTT)

NR 22-38 sec

NAPLEX 2022 (25 decks)

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