CACP Domain 4 Dosing

Question 1

Aspirin Dosing

Answer 1

325 mg x1 IR, then 81 mg PO daily

Question 2

Aspirin Stroke/TIA Dosing

Answer 2

81 mg PO daily

Question 3

Clopidogrel Dosing (NSTEMI)

Answer 3

300 mg PO x1, then 75 mg PO daily

Question 4

Clopidogrel Dosing (STEMI, fibrinolytic)

Answer 4

300 mg PO x1, then 75 mg PO daily

Question 5

Clopidogrel Dosing (STEMI, PCI)

Answer 5

600 mg PO x1, then 75 mg PO daily

Question 6

Prasugrel Dosing

Answer 6

60 mg PO x1, then 10 mg PO daily

Question 7

Prasugrel Dosing (Asian or weight < 60 kg)

Answer 7

60 mg PO x1, then 5 mg PO daily

Question 8

Ticagrelor Dosing

Answer 8

180 mg PO x1, then 90 mg PO BID

Question 9

Ticagrelor Dosing if > 1 year

Answer 9

60 mg PO BID based on ischemic risk

Question 10

Avoid Prasugrel if (3)

Answer 10

Stroke/TIA, age >/= 75 years, if NSTEMI and no PCI

Question 11

Heparin aPTT target

Answer 11

1.5 - 2.5 x baseline

Question 12

Argatroban aPTT target

Answer 12

1.5 - 3.0 x baseline

Question 13

Bivalirudin aPTT target

Answer 13

1.5 - 2.5 x baseline

Question 14

Heparin aPTT target for ACS

Answer 14

1.5 - 2 x baseline

Question 15

Heparin anti-Xa target

Answer 15

0.3 - 0.7 units/mL

Question 16

Heparin dosing (IV)

Answer 16

80 units/kg x1, then 18 units/kg/hr

Question 17

Heparin VTE prophylaxis dosing (SQ)

Answer 17

5000 units q 8 - 12 hrs

Question 18

Heparin dosing for ACS (IV)

Answer 18

60 units/kg x1, then 12 units/kg/hr

Question 19

Enoxaparin VTE prophylaxis

Answer 19

30 mg BID (hip or knee replacement, first dose post surgery) or
40 mg daily (hip or knee replacement with first dose pre-surgery, abdominal surgery, acute medical illness patients)

If CrCl < 30, 30 mg daily

Question 20

Argatroban starting dose (HIT)

Answer 20

2 mcg/kg/min

Question 21

Bivalirudin starting dose (HIT)

Answer 21

0.15 mg/kg/hr

Question 22

Bivalirudin dosing (PCI)

Answer 22

0.75 mg/kg, then 1.75 mg/kg/hr

Question 23

Argatroban dosing (PCI)

Answer 23

350 mcg/kg, then 25 mcg/kg/min

Question 24

Fondaparinux dosing

Answer 24

SQ 5 mg daily if wt < 50 kg, 7.5 mg daily if wt 50 - 100 kg, 10 mg daily if wt > 100 kg

Question 25

Fondaparinux VTE prophylaxis and up to how many days

Answer 25

2.5 mg daily SQ up to 21 days

Question 26

Eptifibatide dosing

Answer 26

180 mcg/kg x1 IV, 180 mcg/kg x1 10 mins later, 2 mcg/kg/min continuous

Question 27

Eptifibatide time limit

Answer 27

Up to 24 hours post PCI

Question 28

Tirofiban dosing

Answer 28

25 mcg/kg IV, then 0.15 mcg/kg/min

Question 29

Tirofiban time limit

Answer 29

Up to 18 hours post PCI

Question 30

Reteplase dosing (STEMI)

Answer 30

10 units IV over 2 minutes, wait 30 mins, then 10 units over 2 minutes

Question 31

Tenecteplase dosing

Answer 31

30 - 50 mg IV x 1 based on weight

Question 32

Alteplase dosing (PE)

Answer 32

100 mg over 2 hours

Question 33

Alteplase dosing (Ischemic stroke)

Answer 33

0.9 mg/kg IV (max 90 mg): 10% of dose over 1 min, remaining over 1 hour

Question 34

Apixaban prophylaxis areas

Answer 34

Knee or Hip surgery

Question 35

Rivaroxaban prophylaxis areas

Answer 35

Knee or Hip surgery or acutely medical ill

Question 36

Dabigatran prophylaxis areas

Answer 36

Hip surgery

Question 37

Argatroban ACT Target Range

Answer 37

300 - 450 seconds

Question 38

Enoxaparin in STEMI

Answer 38

Bolus 30 mg x 1, then 1 mg/kg BID