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Doacs Flashcards

1
Q

Which DOACs inhibit thrombin and which inhibit factor Xa

A

Dabigatran inhibits thrombin

Edoxaban, apixaban, rivaroxaban inhibit factor xa

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2
Q

Andexanat alpha is the antidote for…

A

Apixaban
Rivaroxaban

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3
Q

Which DOAC doesnt have an antidote

A

Edoxaban

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4
Q

Ondexxya is also known as

Whats its indication

A

Andexanat alpha

Apixaban
Rivaroxaban

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5
Q

What is dabigatrans antidote

A

Idarucizumab (praxbind)

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6
Q

Praxbind is the brand name for

A

Idarucizumab

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7
Q

Whats anticoagulant is preferred in non valvular AF

A

DOACs

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8
Q

What anticoagulant is preferred in valvular AF

A

Warfarin

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9
Q

What causes more bleeding, DOACs or warfarin

A

Warfarin

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10
Q

When would you reduce/half the dose of a DOAC

A

ABCD

aged 80 or over
Body weight <61/60kg
Crcl 15-50
Drugs verapamil, Amiodarone, erythromycin, ciclosporin

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11
Q

What eGFR would you NOT use a doac in

A

EGFR <15ml/min/1.73m

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12
Q

When would you use a DOAC in stroke prophylaxis

A

If they have at least one of the chadvasc risk factors

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13
Q

Which is the only DOAC used in acute coronary syndromes with aspirin and clopidogrel

Whats the dose?

A

Rivaroxaban
2.5mg BD

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14
Q

Which DOACs are OD and which are BD

A

Rivaroxaban and edoxaban are OD

apixaban and dabigatran are BD

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15
Q

Rivaroxaban dose for VTE prophylaxis

A

10mg OD

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16
Q

When would DOACs be given in VTE prophylaxis

A

In elective hip/ knee surgery after LMWH or low dose aspirin

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17
Q

Rivaroxaban dose for stroke prophylaxis

A

20mg OD

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18
Q

Apixaban dose for VTE prophylaxis

A

2.5mg BD

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19
Q

Apixaban dose for stroke prophylaxis

A

5mg BD

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20
Q

What monitoring requirement is important in DOAC use

A

Renal/ kidney

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21
Q

DOACs are contraindicated in which syndrome? Why?

A

Antiphospholipid

It creates antibodies which cause increased risk of blood clots, risking patient of recurrent thrombotic events

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22
Q

What do patients on DOACs have to carry at all times

A

Patient alert cards

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23
Q

DOAC indications

A

Prophylaxis of VTE in elective hip or knee replacement surgery
Confirmed VTE treatment
Prophylaxis of stroke and embolism in NON VALVULAR AF PATIENTS

Rivaroxaban used in prophylaxis of ACS (2.5mg OD)

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24
Q

DOACs duration of action

A

12 hours - apixaban and dabigatran

24 hours - rivaroxaban and edoxaban

25
Is routine monitoring required in DOACs
No
26
DOACs - monitor signs of …. Stop if …… occurs
Bleeding or anaemia Severe bleeding
27
Which DOAC needs to be taken with food, at which strength Why?
Rivaroxaban when given at strengths 15mg and 20mg need to be taken with food as it could affect the stomach causing GI bleeds
28
In stroke prophylaxis apixaban is given as 5mg BD, when would you reduce this dose to 2.5mg BD They must have how many factors?
If they have at least 2 of the following factors: Aged 80 or more Body weight <60kg CrCl 15-50ml/min Creatinine 133mmol/l or more ABCC
29
Rivaroxaban dose for confirmed DVT or PE With food or without?
Initially 15mg BD for 21 days (3weeks) then 20mg maintenance WITH FOOD
30
Rivaroxaban dose for prophylaxis of stroke and systemic embolism in patients with non valvular AF with at least 1 of the chadvasc factors
20mg OD
31
When is the only time rivaroxaban is given BD
Acute coronary syndrome 2.5mg BD Confirmed DVT/PE - 15mg BD for 21 days then 20mg daily
32
Rivaroxaban is given in prophylaxis of atherombotic events in ACS for a duration of……
12 months 2.5mg BD with food with aspirin or with both aspirin and clopidogrel
33
Rivaroxaban Dose for prophylaxis of atherombotic events in patients with artery disease or symptomatic peripheral artery disease at high risk of ischaemic events
2.5mg BD with aspirin
34
Dabigatran dose for prophylaxis of VTE following total knee replacement surgery in 18-74 yrs
110mg to be taken 1-4 hrs after surgery followed by 220mg OD for 10 days starting the day after surgery
35
Dabigatran dose for prophylaxis of VTE following total knee replacement surgery in 75yrs and over
75mg taken 1-4 hrs after surgery followed by 150mg OD for 10 days starting day after surgery
36
Dabigatran dose for prophylaxis of VTE following total knee replacement surgery in patients taking concomitant Amiodarone or verapamil
75mg 1-4 hrs after surgery followed by 150mg OD for 10 days starting day after surgery
37
Prophylaxis of VTE for knee replacement rivaroxaban dose
10mg OD for 2 weeks (14 days)
38
Prophylaxis for VTE for hip replacement rivaroxaban dose
10mg OD for 5 weeks (35 days)
39
Rivaroxaban dose prophylaxis of recurrent DVT or PE
10mg OD 20mg OD in high risk
40
Treatment of DVT/PE or prophylaxis of recurrent DVT/PE dabigatran dose
18-74yrs: 150mg BD for at least 5 days 75-79yrs: 110-150mg BD Adults 80yrs or over: 110mg BD
41
Prophylaxis of stroke dabigatran dose
110-150mg BD
42
Rivaroxaban brand name
Xarelto
43
Dabigatran brand name
Pradaxa
44
Whats the cautionary label for ALL DOACS
Read the additional information given with this medicine
45
Dabigatran cautionary label
Swallow this medicine whole. Do not chew or crush
46
Rivaroxaban cautionary label
Take 15mg and 20mg with food or just after a meal
47
Apixaban prophylaxis VTE for knee replacement dose
2.5mg BD for 10-14 days
48
Apixaban prophylaxis VTE for hip replacement dose
2.5mg BD for 32-38 days
49
Treatment of DVT /PE apixaban dose
10mg BD for 7 days Maintenance 5mg BD daily
50
Apixaban dose prophylaxis of recurrent DVT/PE
2.5mg BD
51
Apixaban prophylaxis of stroke dose, when would you reduce this dose and to what?
5mg BD Reduce if aged 80 or over, body weight 60 or less, crcl 15-50 or creatinine >133 Reduce to 2.5mg BD
52
Edoxaban prophylaxis of stroke/AF
In 60kg or less give 30mg OD In >60kg give 60mg OD
53
Edoxaban dose for treatment of DVT/PE
In 60kg or less give 30mg OD In >60kg give 60mg OD
54
Edoxaban dose in prophylaxis of recurrent DVT/PE
In 60kg or less give 30mg OD In >60kg give 60mg OD
55
When would you reduce edoxaban dose 60mg OD and reduce to what
Weight 60kg or less Crcl 15-50 Drugs- ketoconazole, dronedarone, cyclosporine, erythromycin Reduce to 30mg OD
56
When would you reduce apixaban 5mg BD and to what How many factors
At least 2 out of 3 factors: Age Weight Creatinine clearance Creatinine >133 Reduce to 2.5mg
57
When would you reduce dabigatran 150mg BD and to what
Age 75-79, crcl 30-50ml/min and drugs (verapamil, Amiodarone): 110-150BD Age 80 and over 110mg BD
58
DOAC contraindications
Antiphospholipid syndrome Significant risk factors of bleeding Concomitant treatment with other DOACs eGFR <15ml/min/1.73m Switching from rivaroxaban to warfarin (stop warfarin first to reduce risks of bleeding)

Cardiovascular (9 decks)

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