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Pre-reg > DOACs > Flashcards

DOACs Flashcards

1
Q

What characteristics do you need to have to have a DOAC prescribed for stroke prophylaxis?

A

CHADSVASC- women= 2, men= 1

Congestive heart failure
Hypertension
Age 75+
Diabetes
Stroke/TIA/Thromboembolism
Vascular disease (PAD/prev MI/Aortic plaque)
Age below 75
Sex (women 2)

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2
Q

Factors which require a dose reduction

A

AGE- 75- 80
Body weight- below 60kg
CrCl= 15-50mmol/L
Drugs- interacting = verapamil, amiodarone, erythromycin and ciclosporin

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3
Q

Which doacs are given OD

A

Rivaroxaban
Edoxaban

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4
Q

Which doacs are given BD

A

Apixaban
Dabigatran

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5
Q

DOAC indications

A

Stroke prophylaxis and treatment
VTE prophylaxis and treatment
Rivaroxaban- ACS

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6
Q

DOAC monitoring

A

Renal function
Weight
Bleeding/Bruising

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7
Q

MOA of DOACS

A

Riv and Apix= Direct inhibitor of factor Xa
Edox= Direct and reversible inhibitor of factor Xa
Dab= Direct thrombin inhibitor

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8
Q

What strengths of Rivaroxban needs to be taken with food

A

15-20mg

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9
Q

Dose of Apixaban for stroke prophylaxis

A

5mg BD

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10
Q

When is a dose reduction needed for apixaban? and what is the dose?

A

Age- above 80
Body weight- under 60
Creatinine= 133micromol/L
CrCl= 15-29ml/min

Dose= 2.5mg BD

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11
Q

Apixaban- VTE prophylaxis dose

A

2.5mg BD
Knee = 10-14 days
Hip= 32-38 days

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12
Q

Apixaban- VTE treatment dose

A

10mg BD for 7 days, then maintenance 5mg BD

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13
Q

Rivaroxaban- VTE prophylaxis dose

A

10mg OD
knee= 2 weeks
hip= 5 weeks

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14
Q

Rivaroxaban- VTE treatment dose

A

15mg BD for 21 days then 20mg OD

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15
Q

Rivaroxaban- Stroke prophylaxis dose

A

20mg OD

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16
Q

Rivaroxaban- atherothrombotic events following ACS dose

A

2.5mg for 12 months

17
Q

Edoxaban - prophylaxis stroke/VTE , Treatment DVT, recurrent DVT

A

Above 61kg= 60mg OD
Below 61kg= 30mg OD

18
Q

Dabigatran- prophylaxis of VTE knee replacement

A

18-74 yo= 110mg 1-4 hours after surgery then 220mg for 10days

75+ =75mg 1-4 hours after surgery then 110mg for 10days

19
Q

Dabigatran- Treatment VTE, Prophylaxis of recurrent DVT

A

18-74 yo= 150mg BD for at least 5 days

75-79 = 110- 150mg BD

80+= 110mg BD

20
Q

Dabigatran- stroke prophylaxis

A

Age 18-74= 150mg BD
Age 75-79= 110mg- 150mg BD
Age 80+= 110mg BD

21
Q

Edoxaban interactions- requiring dose reduction

A

Erythromycin, ciclosporin, ketoconazole, dronedarone

22
Q

Dabigatran interactions- requiring dose reduction

A

Verapamil and amiodarone

23
Q

Rivaroxaban and Apixaban antidote

A

Andexanet Alpha (ONDEXXYA)

24
Q

Edoxaban antidote

A

there’s not one

25
Q

Dabigatran antidote

A

Idarucizumab (praxbind)

26
Q

What should all DOACS come with

A

warning card (Label 10)

27
Q

Dabigatran cautionary labels

A

warning card
Swallow whole/don’t crush or chew- label 25

28
Q

Rivaraoxban cautionary labels

A

warning card
take with or just after food - label 21

Pre-reg (13 decks)

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