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

The only DOAC used in ACS is …

Answer 3

Rivoraxaban

Question 4

Example of DOACS used once daily

Answer 4

RE
Rivaroxaban
Edoxaban

Question 5

DOACs used BD

Answer 5

AD
Apixaban
Dabigatran

Question 6

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

Answer 6

10mg OD- VTE
20mg OD - Stroke

Question 7

Whats the prophylaxis dose of Apixaban for VTE and stroke

Answer 7

VTE- 2.5mg BD
Stroke - 5mg BD

Question 8

What organ do you monitor while on DOACS

Answer 8

Monitor kidneys

Question 9

DOACS are contraindicated in….

Answer 9

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

Question 10

Facts about DOACs

Answer 10

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

Question 11

Which DOAC inhibit Thrombin

Answer 11

Dabigatran

Question 12

DOACs that inhibit factor Xa inhibitor

Answer 12

Apixaban
Edoxaban
Rivoraxaban

Question 13

A DOAc with no antidote

Answer 13

Edoxaban

Question 14

What’s the reversal agent with Apixaban and Rivoraxaban

Answer 14

Andexanet Alfa (Ondexxya)

Question 15

Indication of DOACs

Answer 15

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 16

MOA of warfarin

Answer 16

Inhibits Vit K decreasing clotting factors 2, 7

Question 17

What’s the MHRA warning for rivaroxaban?

Answer 17

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

Question 18

State when to reduce the dose of 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 18

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

Question 19

What is the antidote for Dabigatran( pradaxa)

Answer 19

Idarucizumab( praxbind)

Question 20

Antidote for Heparin

Answer 20

Protamine

Question 21

Antidote for Warfarin

Answer 21

Vit K or phytomenadione

Question 22

Whats the cautionary label for Dabigatran

Answer 22

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

Question 23

3 different strength of Pradaxa

Answer 23

75mg , 110mg and 150mg

Question 24

Indication of Tranexamic acid

Answer 24

Local fibrinolysis
Menorrhagia
Hereditary angioedema
Epistaxis( nose bleed)

Question 25

Adult dose for Tranexamic acid used in Fibrinoysis

Answer 25

1-1.5g BD or TDS

Question 26

Adult dose of tranexamic acid for menorrhagia (heavy period)

Answer 26

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

Question 27

Dose of Tranexamic acid for nose bleed

Answer 27

1g TDS for 7days

Question 28

Indication of Tranexamic acid as a P medication

Answer 28

Menorrhagia

Question 29

Caution with Tranexamic acid

Answer 29

Increase risk of DVT when taken with contraceptive pill

Question 30

Contraindications of Tranexamic acid

Answer 30

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

Question 31

Red flags for pt on Tranexamic acid

Answer 31

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