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Anticoagulation and Blood Disorders > Anticoagulation > Flashcards

Anticoagulation Flashcards

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1
Q

What are the indications for unfractionated heparin?

A

VTE Prophylaxis
VTE Treatment
ACS/STEMI Treatment

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2
Q

What are the indications for enoxaparin?

A

VTE Prophylaxis
VTE Treatment
UA/NSTEMI Treatment
STEMI Treatment

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3
Q

What are the indications for dalteparin?

A

VTE Prophylaxis
UA/NSTEMI Treatment

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4
Q

What are the indications for apixaban?

A

Nonvalvular AF (Stroke Prophylaxis)
DVT/PE Treatment
DVT Prophylaxis (Hip/Knee Surgery)

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5
Q

What are the indications for rivaroxaban?

A

Nonvalvular AF (Stroke Prophylaxis)
DVT/PE Treatment
DVT Prophylaxis (Hip/Knee Surgery)
VTE Treatment (Acutely Ill Medical Patients)
Reduction of Major CVD Events (PAD/CAD)

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6
Q

What are the indications for edoxaban?

A

Nonvalvular AF (Stroke Prophylaxis)
DVT/PE Treatment

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7
Q

What are the indications for dabigatran?

A

Nonvalvular AF (Stroke Prophylaxis)
DVT/PE Treatment
Decrease recurrence of DVT/PE
DVT Prophylaxis (Hip surgery)

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8
Q

What are the indications for bivalirudin?

A

PCI
HIT

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9
Q

What are the indications for argatroban?

A

PCI
HIT

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10
Q

What are the indications for warfarin?

A

Stroke Prophylaxis in patients with mechanical heart valves or mitral stenosis
VTE Prophylaxis/Treatment in patients with antiphospholipid syndrome or mechanical heart valves

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11
Q

What are the indications for fondaparinux?

A

VTE Prophylaxis/Treatment

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12
Q

What anticoagulant(s) can be used for stroke prophylaxis in nonvalvular patients?

A

Apixaban
rivaroxaban
edoxaban
dabigatran

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13
Q

What anticoagulant(s) can be used for DVT prevention in KNEE/HIP surgery?

A

Knee: apixaban, rivaroxaban
Hip: apixaban, rivaroxaban, dabigatran

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14
Q

Which anticoagulant(s) can be used for treatment of STEMI?

A

UFH
Enoxaparin

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15
Q

Which anticoagulant(s) can be used for treatment of ACS?

A

UFH

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16
Q

Which anticoagulant(s) can be used for treatment of UA/NSTEMI?

A

enoxaparin
dalteparin

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17
Q

Which anticoagulant provides reduced risk of major CVD events in patients with PAD or CAD?

A

rivaroxaban

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18
Q

Which anticoagulant is indicated for PCI?

A

argatroban
bivalirudin

19
Q

Which anticoagulant is indicated for HIT?

A

argatroban
bivalirudin
Fondaparinux (off-label)

20
Q

Heparin dosing:
Prophylaxis of VTE

A

5000 units SC Q8-12H

21
Q

Heparin dosing:
VTE Treatment

A

80 units/kg bolus then 18 units/kg/hr

22
Q

Heparin dosing:
ACS/STEMI

A

60 units/kg bolus then 12 units/kg/hr

23
Q

Enoxaparin dosing:
VTE Prophylaxis

A

30 mg Q12h or 40 mg Q24h
if CrCl < 30: 30 mg Q24h

24
Q

Enoxaparin dosing:
VTE Treatment or UA/NSTEMI

A

1 mg/kg Q12h or
For VTE Treatment Inpatient only:
1.5 mg/kg Q24h
if CrCl < 30: 1 mg/kg Q24h

25
Q

Enoxaparin dosing:
STEMI and < 75 yo

A

30 mg bolus then 1 mg/kg Q12h
if CrCl < 30: 30 mg bolus then 1 mg/kg Q24h

26
Q

Enoxaparin dosing:
STEMI and 75+ YO

A

NO BOLUS. 0.75 mg/kg Q12h
if CrCl < 30: NO BOLUS. 1 mg/kg Q24h

27
Q

Apixaban dosing:
Nonvalvular AF Stroke Prophylaxis

A

5 mg BID

If 2/3 are met - SCr > 1.5; Age >80, Wt < 60 kg then 2.5 mg BID

28
Q

Apixaban dosing:
DVT/PE Treatment

A

10 mg BID for 7 days then 5 mg BID
Do not dose reduce.

29
Q

rivaroxaban dosing:
Nonvalvular Afib Stroke Prophylaxis

A

15-20 mg daily with EVENING meal

30
Q

rivaroxaban dosing:
DVT/PE Treatment

A

15 mg BID x 21 days then 20 mg daily with food.

31
Q

What if I miss my rivaroxaban dose?

A

If taking 2x daily: May double up, ensure 30 mg/day is taken then resume normal.
If taking 1x daily: Take when remember or skip. Do not double up. Then resume normal.

32
Q

Edoxaban dosing

A

CrCl > 95: Contraindicated

DVT/PE Dosing:
Start after 5-10 days of parenteral anticoagulation

33
Q

Dabigatran dosing

A

Treatment of DVT/PE:
Start after 5-10 days of parenteral anticoagulation

34
Q

What if I miss my dabigatran dose?

A

Take dose unless within 6 hours of next dose. Do not double up.

35
Q

Warfarin dosing:

A

Most people: 10 or less mg for first two days then adjust on INR

5 or less mg daily: for Elderly, malnourished, high bleed risk, liver impairment, HF, concurrent meds that raise INR

36
Q

What are the safety considerations for heparin?

A

Contraindications: Active Bleed

Warnings: high risk for med errors, confirm correct concentration

Side Effects: bleeding, thrombocytopenia, HIT, hyperkalemia

37
Q

What are the safety considerations for enoxaparin?

A

Boxed Warning: neuraxial anesthesia increases risk of hematoma and subsequent paralysis

Contraindication: Major active bleeding and history of HIT

Side effects: bleeding, anemia, injection site reactions of bruising/hematoma, and decreased platelets

38
Q

What are the safety considerations for DIRECT Xa Inhibitors?

A

Boxed Warning: neuraxial anesthesia (spinal/epidural) increases risk of hematoma and subsequent paralysis

Contraindications: Active pathological bleeding

Warning: Not recommended for patients with mechanical heart valve or antiphospholipid syndrome

Side Effects: bleeding

39
Q

What are the safety considerations of Fondaparinux?

A

Boxed Warning: neuraxial anesthesia (spinal/epidural) increases risk of hematoma and subsequent paralysis

Contraindication: Severe renal impairment (CrCl < 30)

Side effects: bleeding

40
Q

What are the safety considerations of dabigatran?

A

Boxed Warning: neuraxial anesthesia (spinal/epidural) increases risk of hematoma and subsequent paralysis

Contraindication: Mechanical heart valves

Side Effects: Dyspepsia, gastritis-like symptoms, bleeding (GI bleeding)

41
Q

What are the safety considerations of the IV Direct Thrombin Inhibitors?

A

Side Effects: bleeding

42
Q

What are the safety considerations of warfarin?

A

Contraindications: Pregnancy (unless patient has mechanical heart valve)

Warnings: tissue necrosis/Gangrene, HIT, and pharmacogenomic considerations of increased bleed with CYP2C92 or CYP2C93 alleles or VKORC1 polymorphism

Side effects: bleeding/bruising, skin necrosis, purple toe syndrome

43
Q
A

Anticoagulation and Blood Disorders (1 decks)

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