Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm > Anticoagulation > Flashcards

Anticoagulation Flashcards

1
Q

Atrial Fibrillation: Common type of

A

arrhythmia

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

Atrial Fibrillation: Incidence increase with

A

age

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

Atrial Fibrillation: AF increases the risk of

A

stroke

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

Atrial Fibrillation: Responsible for 5-20% of all

A

strokes

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

Atrial Fibrillation: Stroke risk even in ____ AF

A

asymptomatic

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

Paroxysmal AF

A
  • AF that stops within 7 days

- Episodes can happen at random frequencies

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

Persistent AF

A

continuous AF that lasts longer than 7 days

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

Long-standing persistent AF

A

continuous AF that lasts longer than a year

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

Permanent AF

A

This is when you decide you’re not even gonna bother trying to fix it anymore.
Accepting that you have AF can actually help your symptoms

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

Nonvalvular AF

A

When you have AF but no rheumatic mitral stenosis, no prosthetic heart valve, no valve repair

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

The CHA2DS2-VASc score

A

Used to assess the risk of stroke in patients with AF

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

How do you decide to do anticoagulation therapy

A

the risk of thromboembolism will determine anticoagulation therapy, not the presentation of the AF

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

What do you recomend for CHA2DS2-VASc score ≥ 2 (men)

A

Oral anticoagulants

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

What do you recomend for CHA2DS2-VASc score ≥ 3 (women)

A

Oral anticoagulants

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

What do you recomend for CHA2DS2-VASc score 1 (men)

A

Oral anticoagulant to reduce thromboembolic stroke may be considered

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

What do you recomend for CHA2DS2-VASc score 2 (women)

A

Oral anticoagulant to reduce thromboembolic stroke may be considered

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

What do you recomend for CHA2DS2-VASc score 0 (men)

A

It is reasonable to omit anticoagulant therapy

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

What do you recomend for CHA2DS2-VASc score 1 (women)

A

It is reasonable to omit anticoagulant therapy

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

Except in AF with moderate- to -severe mitral stenosis or a mechanical heart valve
what does this mean, its on slide 7 of the anticoagulant

A

email her

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

___ ___ score has been validated as having the best predictive value for intracranial bleeding

A

HAS BLED

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

HAS BLED score: A score of ≥ 3 indicates

A

high risk and alerts the provider that close monitoring is warranted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HAS BLED score: The score also takes other risk factors into account and may

A

offer opportunity for modification of reversible risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HAS BLED stands for

A 
Hypertension 
Abnormal renal or liver function 
Stroke 
Bleeding 
Labile INRs
Elderly 
Drugs or alcohol in excess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HAS BLED: hypertension criteria

A

SBP over 160

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
the HAS BLED system identifies hypertension of SBP over 160 to be
a risk factor that we want to improve
26
HAS BLED: Labile INRs criteria
therapeutic INRs less than 60% of the time
27
Direct Oral Anticoagulant (DOAC) examples
Dabigatran Rivaroxaban Apixaban Endoxaban
28
Vitamin K Antagonist (VKA) example
Warfarin
29
DOACs are recommended over warfarin in DOAC-eligible patients with
AF
30
For patients with AF, who have mechanical heart valves, ____ is recommended
warfarin
31
For patients with AF, who have ___ ____ valves, warfarin is recommended
mechanical heart valves
32
For patients with AF (except ____ or ____) who are unable to maintain a therapeutic INR with warfarin, a DOAC is recommended
mod-severe mitral stenosis or a mechanical heart valve
33
For patients with AF (except mod-severe mitral stenosis or a mechanical heart valve) who are unable to maintain a therapeutic INR with
warfarin, a DOAC is recommended
34
For patients with nonvalvular AF with a CHA2DS2-VASc score of 2 or greater and who have end-stage CKD (CrCl < 15 mL/min) or are on HD, it is reasonable to prescribe
warfarin or another oral anticoagulant
35
In patients who are eligible for oral anticoagulation therapy, we recommend
DOACs over VKA
36
In patients on warfarin with consistently low time in INR therapeutic range (<65%) we recommend
considering interventions to improve or switching to DOACs
37
Dabigatran
Direct thrombin inhibitor Poor bioavailability Renal excretion, not hepatic
38
Rivaroxaban, Apixaban, Edoxaban
- Factor Xa inhibitors - Hepatic metabolism - Rivar and Edoxa need renal dosing, Apixa does not - Edoxa has no antidote
39
Even though Apixa might not need renal dosing,
Apixa and the other 3 DOACs all need the patient to have their renal function tested and hepatic function tested. Then get them re-tested yearly.
40
DOACs in Atrial Fibrillation: Their primary efficacy is for
stroke or systemic embolism
41
DOACs compared to warfarin for treating AF
All DOACs are at least as good as warfarin, Dabig and Apixa are even better than warfarin
42
DOACs compared to warfarin for treating
All DOACs are way better than warfarin
43
DOACs compared to warfarin for treating
Only Dabig is better than warfarin
44
DOACs compared to warfarin for treating
Apixa and Edoxa are better than warfarin
45
DOACs compared to warfarin for mortality in general
All DOACs have 10% less mortality, only Apixa is significantly lower than warfarin
46
What are the 4 reasons to reduce the dose of Apixa
If they're 80 years old or older If SCr is 1.5 or more If the weigh 60 kg or less IF you're giving it with P-gp/CYP inhibitors
47
What are the 2 reasons to reduce the dose of Dabig
CrCl is 15-30 | CrCl is 30-50 while using dronedarone or ketoconazole
48
What is the reason that would tell you that you need to reduce the dose of Edoxa
CeCL 15-50
49
Why would you need to reduce the dose of Rivar
CrCl equal to or less than 50
50
Warfarin facts
100% bioavailability Highly protein bound long half life You have to monitor INR
51
What does these mean on slide 18? - Racemic mixture S-warfarin 5x > than R-warfarin - Small Vd
email her
52
Warfarin patient teaching
Keep your diet consistent and avoid vitamin K
53
What are the 3 Warfarin antidotes
Vitamin K fresh frozen plasma Prothrombin concentrates
54
Virchow's triad
Hypercoagulable state Endothelial injury Venous stasis
55
How does the DVT Wells Score work?
There's a bunch of risk factors, they get 1 point for each factor 1-2 is moderate risk, 3 or more is high risk
56
DVT/PE: All Parenteral medication
``` Unfractionated heparin Low molecular weight heparin Fondaparinux Bivalirudin Argatroban Thrombolytics ```
57
DVT/PE: Parenteral medication that are indirect thrombin inhibitors
Unfractionated heparin Low molecular weight heparin Fondaparinux
58
DVT/PE: Parenteral medication that are direct thrombin inhibitors
Bivalirudin Argatroban Thrombolytics
59
DVT/PE: Oral medication
``` Apixaban Betrixaban Dabigatran Edoxaban Rivaroxaban Warfarin ```
60
What do you recommend for a proximal DVT of PE
Long term (3 months) anticoagulant therapy
61
What do you recommend for DVT of the leg or PE when they don't have cancer
DOAC for 3 months (long term treatment) (Dabig, rivar, apixa, or edoxa). 2nd line treatment is vitamin K antagonist
62
What do you recommend for DVT of the leg or PE if they have cancer
LMWH for 3 months (long term). DOACs and VKA are 2nd line
63
DOAC dosing for VTE: Switching to oral after 5-10 days of IV anticoagulant therapy
1. Give Dabig (but not if they're on a P-gp inhibitor and have CRCL less than 50, or just CrCl less than 30) 2. Or you can give Edoxa
64
is slide 27 saying you should give Edoxa if they meet the criteria like CrCl 30-50 etc?
email her
65
DOACs that are approved as meds you can use to begin therapy
Apixaban and rivaroxaban are approved to initiate therapy. Dabigatran and Edoxaban are not.
66
initiate oral monotherapy: Avoid Apixa if
SCr is more than 2.5
67
Initiate oral monotherapy: Avoid Rivar if
CrCl is less than 30
68
Fondaparinux for VTE is dosed based on
body weight
69
To reverse Dabig,
give Idaruc
70
To reverse Apixa and Rivar,
give Andexxa
71
Andexxa
It's given to reverse Apixa and Rivar It works in about 2 hours You should restart anticoagulation therapy asap ADRs are UTI and peneumonia
72
Andexxa dose is based on
the FXa inhibitor (Rivar or Apixa) the dose of the inhibitor and the time since the last dose of the inhibitor
73
Antidotes: Indirect Thrombin Inhibitors
Protamine sulfate
74
Antidotes: Vitamin K antagonist
Vitamin K
75
Antidotes: Dabigatran
Idaruizumab
76
Antidotes: Apixaban
Andexxa
77
Antidotes: Rivaroxaban
Andexxa

Pharm (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions