Beale Flashcards
Rivaroxiban
15 mg BID with food for first 21 days
Apixaban
10 mg BID for 7 days
Then 5 mg BID
Dabigatran
150 mg BID
Lepirudin Bolus
0.2 - 0.4 mg/kg IV
Lepirudin Maintenance
0.1 - 0.15 mg/kg/hour IV
UFH for prophylaxis
5,000 units SC every 12 hours
Apixiban for Prophylaxis
2.5 mg BID
Enoxaparin for prophylaxis
40 mg SC daily
Enoxaparin prophylaxis for patient having knee replacement surgery
30 mg SC every 12 hours
Dalteparin prophylaxis for low-moderate risk
2500 units SC Once daily
Dalteparin prophylaxis for high risk
5000 units once daily
Routine monitoring for efficacy is not required for most patient on LMWH except _______ (4 groups) _____ is measured
Pregnant woman CrCl < 30 ml/min Obese patient Newborn & Pediatric patient Anti-Xa levels
Enoxaparin dosing
1 mg/kg SC every 12 hours or 1.5 kg/mg daily
Tinzaparin dosing
175 anti-Xa IU/kg daily
If possible, ____ should be used in place of a LMWH in patient with renal insufficiency
UFH
Tinzaparin is contraindicated in patient with CRCl < _____
60 ml/min
In patient with renal insufficiency, decease Enoxaparin to _____ when CrCl < 30 ml/min
1 mg/kg sc daily
Anti-Xa levels should be obtained after the ___dose and drawn ____ hrs after the injection to measure peak activity
2nd or 3rd
4
In heparin reversal, use __ mg of protamine for each _____ units of UFH administered
1
100
LMWH has ____ half life, _____ bioavailability, and lower incidence of ____ and of major bleeding than UFH
Longer
Better
HIT
Which has a more predictable dose response? UFH or LMWH
LMWH
A therapeutic range for anti-Xa has not been established for _____
Fondaparinux
There has been no report of ______ in patient with Fondaparinux , therefore routine monitoring of ______ is not necessary
HIT
Platelet
Since _____ does not bind to fondaparinux, patient with uncontrolled bleeding on Fondaparinux should receive ______
Protamine
Recombinant factor VIIa
What anticoagulants can patient with HIT use?
Lepirudin
Argatroban
_____ has an indication for HIT, but that’s usually during percutaneous coronary intervention
Bivalirudin
_____ for VTE takes place approximately 1 week after initial treatment began
Maintenance therapy
Patient with stable INR should be monitored once every ____ weeks
12
These anticoagulant are contraindicated in patient with CRCl of less than 30 ml/min
Fondaparinux
Rivaroxiban
Tinzaparin is contraindicated in patient with CrCl of less than ______
60 ml/min
Binge drinking ____ INR, chronic alcohol ingestion ____ INR
Increase
Decrease
Diagnosis of HIT is based on 3 things:
Platelet count
Presence of thrombosis
Presence of heparin-dependent antibodies
Name the component of 4T score for predicting the likelihood of HIT
Thrombocytopenia
Timing
Thrombosis
oTher cause of thrombocytopenia
Argatroban dosing in patient with HIT
2 mcg/kg/min IV continuous infusion
Desirudin dosing for prophylaxis
15 mg sc every 13 hours up to 12 days
