Cardiovascular 2

Question 1

DOACs are preferred in what type of AF

Answer 1

Non valvular AF

Question 2

List the parameters for DOACs that may require dose reduction

Answer 2

ABCD
Age> or = 80yrs
Body weight= <61/60kg
CRCL=15- 50
Do not give DOAC if CRCL is less than 15
Drugs- Verapamil, amiodarone, erythromycin and ciclosporin

Question 3

What’s the dose of apixaban used in ACS ( heart attack with aspirin/clopidogrel)

Answer 3

2.5mg BD

Question 4

The only DOAC used in ACS is …

Answer 4

Rivoraxaban

Question 5

Example of DOACS used once daily

Answer 5

RE
Rivoroxaban
Edoxaban

Question 6

DOACs used BD

Answer 6

AD
Apixaban
Dabigatran

Question 7

What’s the dose of Rivoraxaban for VTE prophylaxis and stroke

Answer 7

10mg OD- VTE
20mg OD - Stroke

Question 8

Whats the prophylaxis dose of Apixaban for VTE and stroke

Answer 8

VTE- 2.5mg BD
Strike 5mg BD

Question 9

What organ do you monitor while on DOACS

Answer 9

Monitor kidneys

Question 10

DOCS are contraindicated in….

Answer 10

Antiphospholipid syndrome
( immune response which created antibodies which make blood clot increases risk of recurrent thrombotic events

Question 11

Facts about DOACs

Answer 11

Less bleeding
No monitoring requiredd
All have pt alert card
Label 10- take this drug with additional info

Question 12

Which DOAC inhibit Thrombin

Answer 12

Dabigatran

Question 13

DOACs that inhibit factor Xa inhibitor

Answer 13

Apixaban
Edoxaban
Rivoraxaban

Question 14

A DOAc with no antidote

Answer 14

Edoxaban

Question 15

What’s the reversal agent with Apixaban and Rivoraxaban

Answer 15

Andexanet Alfa (Ondexxya)

Question 16

Indication of DOACs

Answer 16

Prophylaxis of stroke and systemic embolism in patients with non Valvular AF
Secondary prevention and tx of DVT/ PE
Prevention of VTE after elective hip or knee replacement surgery

Question 17

MOA of warfarin

Answer 17

Inhibits Vit K decreasing clotting factors 2, 7

Question 18

What’s the MHRA warning for rivaroxaban?

Answer 18

15mg and 20mg tablets should be given with food
Label 21

Question 19

State when to reficed the dose of apixaban Apixaban in prophylaxis of stroke or systemic embolism in non valvular Af and at least one risk factor [ stroke(TIA)HF, diabetes, HTN, age 75 and over

Answer 19

5mg BD to 2.5mg BD
if
ABCC
Age - >or = 80
Weight = <or = 60kg
Creatinine >or = 133micromol/litre
CrCL- 15-29ml/min

Question 20

What is the antidote for Dabigatran( pradaxa)

Answer 20

Idarucizumab( praxbind)

Question 21

Antidote for Heparin

Answer 21

Protamine

Question 22

Antidote for Warfarin

Answer 22

Vit K or phytomenadione

Question 23

Whats the cautionary label for Dabigatran

Answer 23

Label 10
And 25- swallow this medicine whole ,do not chew or crush

Question 24

3 different strength of Pradaxa

Answer 24

75mg , 110mg and 150mg

Question 25

Indication of Tranexamic acid

Answer 25

Local fibrinolysis
Menorrhagia
Hereditary angioedema
Epistaxis( nose bleed)

Question 26

Adult dose for Tranexamic acid used in Fibrinoysis

Answer 26

1-1.5g BD or TDS

Question 27

Adult dose of tranexamic acid for menorrhagia (heavy period)

Answer 27

1g TDS for up to 4days to be initiated when menstruation has started.
Max 4g daily

Question 28

Dose of Tranexamic acid for nose bleed

Answer 28

1g TDS for 7days

Question 29

Indication of Tranexamic acid as a P medication

Answer 29

Menorrhagia

Question 30

Caution with Tranexamic acid

Answer 30

Increase risk of DVT when taken with contraceptive pill

Question 31

Contraindications of Tranexamic acid

Answer 31

Epilepsy, DVT, PE, irregular periods, renal problems and pregnancy

Question 32

Red flags for pt on Tranexamic acid

Answer 32

Discontinue if colour vision change or visual impairment
Coughing up blood or Coughing
Anaphylaxis rxn
SOB, legs or arms painful and swollen, red and warm to touch