Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BNF Cardiovascular > Anticoagulation > Flashcards

Anticoagulation Flashcards

1
Q

Why are anticoagulants used for venous circulation?

A

Blood is faster moving and thrombi are composed of platelets and little fibrin ( as in arteries)

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

Example of a Vit K antagonist

A

Warfarin / Acenocoumarol / Phenidione

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

Onset of action for Warfarin

A

48-72 hours

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

If an immediate effect of Warfarin is needed what does the BNF suggest we do?

A

Bridge with LMWH for 5 days or until INR >2

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

What 2 conditions can Warfarin not be used in?

A

Cerebral artery thrombus and peripheral artery occlusion (first line = aspirin)

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

Target INR for treatment of DVT / PE

A

2.5

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

Target INR for AF

A

2.5

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

Target INR for dilated cardiomyopathy

A

2.5

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

Target INR for MI

A

2.5

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

Target INR for recurrent DVT / PE

A

3.5

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

Target INR for prosthetic heart valves

A

3.5

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

Duration of Warfarin treatment in provoked VTE

A

3 monthd

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

Duration of Warfarin treatment in isolated calf DVT

A

6 weeks

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

Duration of Warfarin treatment in unprovoked DVT /PE

A

3 months (6 months to long term possible)

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

Duration of Warfarin treatment in AF / Heart valves

A

Long term

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

What does the BNF suggest doing to Warfarin if there is haemorrhage?

A

Check INR, Omit dose if necessary, consider reversal agents

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

If a patient has a major bleed on warfarin what does the BNF suggest to do?

A
  1. stop warfarin 2. Phytomenidione by slow IV 3. dried prothrombin complex / fresh frozen plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If a patients INR is >8 and they are on Warfarin what do you do?

A

Stop warfarin, give phytomenidione and repeat if INR is still too high. Restart Warfarin when INR < 5

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

If a patient has an INR of 5-8 with no bleeding on Warfarin - what do you do?

A

Omit warfarin for 1 to 2 doses

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

How many days before surgery should Warfarin be stopped?

A

5 days

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

If you have a Warfarin patient where surgery cannot be delayed and INR >1.5 what do you do?

A
  1. If can delay for 6 - 12 hours give IV Vit K

2. If cant delay dried prothrombin complex + Vit K + check INR

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

Benefit of Heparin

A

Short half life so can be terminated quickly

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

Benefit of LMWH

A

Lower risk of osteoporosis + HIT, no standard montioring, OD dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What anticoagulation medication can be used if a patient has HIT?

A
  1. Danaparoid - used for HIT patients
  2. Argatroban - can be started when thrombocytopenia has resolved
  3. Fondaparinux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Dose of apixaban for stroke prevention in NVAf

A

5mg BD longterm, reduce to 2.5mg BD if patient has 2 of the 3 factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When would you reduce the dose of Apixaban when treating for stroke prevention?

A

If the patient is 1. >80 2. <60kg 3.Cr >133

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment dose of Apixaban

A

10mg BD for 7 days, reduce to 5mg BD for at least 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Dose of Apixaban for prevention of recurrent DVT / PE

A

2.5mg BD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Dose of Apixaban for prevention of VTE in hip replacement

A

2.5mg BD after 12 to 24 hours of surgery. Treat for 32-38 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dose of Apixaban for prevention of VTE in knee replacement

A

2.5mg BDafter 12 to 24 hours of sugery for 10 - 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

At what renal function is Apixaban contraindicated?

A

CrCl<15 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Dose of Dabigatran for prevention of VTE in hip replacement

A

220mg OD for 28 to 35 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Dose of Dabigatran for prevention of VTE in knee replacement

A

220mg OD for 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Dose of Dabigatran for prevention of VTE in stroke prophylaxis

A

150mg BD (reduce to 110mg BD if >80 or on verapamil/amiodarone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment dose of Dabigatran for VTE

A

150mg BD for at least 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

At what CrCL is Dabigatran contraindicated?

37
Q

MHRA warning for DOACS

A

Increased risk of thrombotic events if patient has antiphospholipid syndrome

38
Q

Reversal agent for Dabigatran

A

Idarucizumab

39
Q

Dose of Edoxaban in stroke prophylaxis

A

60mg OD for long term

40
Q

Dose of Edoxaban for treatment of DVT / PE

A

Post 5 days of parenteral, give 60mg OD for at least 3 months

41
Q

Whst is the creatinine cut off for Edoxaban?

A

Crcl <15 ml/min

42
Q

How should Rivaroxaban be taken?

43
Q

Dose of Rivaroxaban for prevention of VTE in hip replacement

A

10mg OD starting 6 to 10 hours post surgery for 35 days

44
Q

Dose of Rivaroxaban for prevention of VTE in knee replacement

A

10mg OD starting 6 - 10 hours post surgery for 14 days

45
Q

Dose of Rivaroxaban for prevention of stroke in NVAF

A

20mg OD longterm

46
Q

Dose of Rivaroxaban in treatment of DVT or PE

A

15mg BD for 3 weeks then 20mg OD for at least 3 months

47
Q

Dose of Rivaroxaban for prevention in recurrent DVT/PE

A

15mg BD for 3 weeks followed by 20mg OD for 3 months

48
Q

Dose of Rivaroxaban in prevention of atherothrombotic events post ACS

A

2.5mg BD (+aspirin) for 12 months

49
Q

What is the CrCl cut off for Rivaroxaban?

A

CrCl<15 ml/min

50
Q

Antidocte for apixaban / Rivaroxaban

A

Andexant aloha (recombinant human factor Xa)

51
Q

What is the mechansim of action behind antiplatlet drugs?

A

Reduce platelet aggregation and inhibit thrombus formation in arteries

52
Q

Examples of antiplatlet drugs

A

Aspirin, Clopidogrel, Ticagrelor

53
Q

If a patient has an NSTEMI how long should clopidogrel be given for?

A

3 months (+ aspirin)

54
Q

If a patinet has a STEMI how long should Clopidogrel be given for?

A

4 weeks ( + low dose aspirin)

55
Q

Contraindications for Aspirin

A

< 16 years ( Reyes syndrome risk), active peptic ulceration,haemophillia

56
Q

Features of Aspirin overdose

A

Tinnitus, deafness, vasodilation, hyperventilation, sweating

57
Q

In adults, when no strength is stated what should be dispensed?

A

300mg aspirin tablets

58
Q

How many aspirin can be sold OTC?

A

pack size of 32 capsules or tablets. Pharmacists can sell up to 100 caps or tablets in justifiable circumstances

59
Q

Warning labels for Aspirin

A

Take with food, Contains aspirin, Do not crush or chew

60
Q

How many days before elective surgery should Clopidogrel be stopped?

61
Q

Why do dipyridamole capsules need to be dispensed in the original container?

A

They contain desiccant in the pack . Any remaining capsules should be discarded after 6 weeks

62
Q

Maximum dose of Edoxaban if given alongside Dronedarone/Ciclosporin/ erythromycin etc

63
Q

MHRA alert for Rivaroxaban

A
  1. DOACs + risk of antiphospholipid syndrome

2. Must be taken with food to increase efficacy

64
Q

At what body weight is Rivaroxaban cautioned?

65
Q

What medication can be used as an adjunct to thromboprophylaxis associated with prosthetic valves

A

Dipyramidole (MR preparation are licensed for secondary prevention of ischemic stroke + TIA)

66
Q

When is prasugrel + aspirin or Ticagrelor + aspirin used in combination and for how long?

A

prevention of atherosclerotic events in patients with ACS for 12 months

67
Q

When is Cangrelor used?

A

In combination with aspirin for the reduction in thrombotic cardiovascular events in patients with CAD undergoing PCI who have not received treatment wiht oral clopidogrel,prasugrel or Ticagrelor and in whom these drugs are not suitable

68
Q

What antiplatlet therapy is required for patients who are selected for PCI with the placement of a coronary stent?

A

DAPT (asprin + clopi/ticagrelor/prasugrel/cangrelor)

Aspirin should continue indefinitely

69
Q

Following PCI, how long should a patient with a bare-metal stent receive clopidogrel for?

70
Q

Following PCI, how long should a patient with a drug elluting-metal stent receive clopidogrel for?

71
Q

How do Glycoprotein IIb/IIA inhibitors work?

A

prevent platelet aggregation by blocking the binding of fibrinogen to receptors on platelets

72
Q

Examples of Glycoprotein IIb/IIa inhibitors

A

Abciximab, Eptifibatide, Tirofiban

73
Q

What is Abiciximab licensed for?

A

as an adjunct to heparin (unfractionated) and aspirin for the prevention of ischemic complications in highrisk patients undergoing PCI. Abiciximab should be used ONCE only

74
Q

What are Tirofiban and Eptifibatide licensed for?

A

prevent early MI in patients wiht unstable angina or NSTEMI

75
Q

What dose of Clopidogrel is given for prevention of atherosclerotic events in PCI?

A

300mg STAT prior to procedure

76
Q

What dose of Clopidogrel is suggested for prevention of atherosclerotic events in ACS (NSTEMI)

A

300mg STAT, 75mg OD for 12 months

77
Q

What dose of Clopidogrel is suggested for prevention of atherosclerotic events in ACS (STEMI)

A

300mg STAT, 75mg OD for 4 weeks at least

78
Q

What are the signs of Heparin induced thrombocytopenia?

A

30% reduction in platelet count, skin allergy, thrombosis. Stop heparin, use an alternative anticoagulant e.g. Danaparoid

79
Q

How can heparin cause hyperkalaemia

A

Inhibition of aldosterone secretion

80
Q

What patients are more at risk of hyperkalaemia from Heparin?

A

Patient with diabetes, chronic renal failure, raised plasma potassium, taking potassium sparring drugs

81
Q

If anti-factor Xa levels are needed, when should they be taken?

A

3 to 4 hours post dose ( aim for anti-factor Xa 0.5-1unit/mL)

82
Q

Dose of Enoxaparin for tx of DVT if <50kg

83
Q

Dose of Enoxaparin for tx of DVT if 50 - 69kg

84
Q

At what CrCl should Tinzaparin be avoided

85
Q

What is urokinase most commonly used for?

A

Occluded central venous catherters (blocked by fibrin clots)

86
Q

What class of anticoagulants can direct acting antivirals interact with (MHRA alert)

A

Vitamin K antagonists - risk of changes to INR monitor closely

87
Q

What anticoagulant is teratogenic?

A

Warfarin - warned women of child bearing potential about the risks

88
Q

Why should patients be warned to contact their Drs if they develop a painful skin rash on warfarin?

A

MHRA alert - risk of calciphylaxis with Warfarin. Most commonly observed in patients wiht known risk factors e.g. end stage renal disease

BNF Cardiovascular (10 decks)

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