Drugs Flashcards
when should warfarin be stopped prior to neuraxial block
4-5 days
confirm normalization of INR prior to needle insertion
what should the INR be to remove the catheter
INR <1.5
if INR is 1.5-3.0- and you’ve removed the catheter, what should you do?
close neuromonitoring!
if INR great 3.0 what should happen to the warfarin dose
warfarin should be held.
Aspirin recommendations for holding prior to neuraxial anesthesia
no contraindications
when should plavix be stopped
stop for 7 days prior to neuraxial block.
if patient has been off plavix between 5-7 days what should be confirmed
restoration of platelet function
when should prasugrel (effient) be stopped
7-10 days.
when should prasugrel (effient) be administered after having a neuraxial block
wait 9 hours after neuraxial block or catheter removal before administrating the drug.
how long should ticagrelor (brillianta) be stopped before neuraxial blockade
5-7 days prior to neuraxial block
when can ticagrelor be administered after a neuraxial block
10 hours
when should ticlopidine be stopped for neuraxial block
stop 14 days prior to neuraxial block
when should LMWH be stopped -Preoperatively:
prophylactic vs treatment dose
wait 10-12 hours after prophylactic dose.
wait 24 hours after treatment dose.
when should LMWH be started postoperatively
catheters should be removed at least 2 hours prior to initiating twice daily dosing regimens.
for single daily dosing of LMWH- catheters can be maintained but should only be removed after how many hours after last dose
catheters can be maintained but should only be removed 10-12 hours after last dose.
subcutaneous heparin 10,000 units per day or less:
no contraindication
subcutaneous heparin greater than 10,000 units per day
use extra caution, check platelet count if >4 days on heparin.
IV heparin stop
2-4 hours prior to catheter removal.
after block when can IV heparin be restarted
1 hour after block
dabigatran
stop 5 days prior to neuraxial block
apixaban
stop 3 days prior to neuraxial bloc
rivaroxaban
stop 3 days prior to neuraxial block
thrombolytics/fibrinolytics/thrombin inhibitors
neuraxial techniques contraindicated except in unusual circumstances
dabigatran administration post neuraxial block
wait 6 hours
