DVT, A fib, PE Flashcards
If your patient has A fib, what are you most worried about?
congestive heart failure and stroke
What is the risk of stroke with A fib?
5X times more likely
What are the 2 types of stroke?
hemmorhagic and embolic
What is a hemorrhagic stroke?l-
BV breaks (25% of all strokes)
What is an embolic stroke?
something breaks off and is in the way
WHen people have a mechanical/artificial valve and have A fib, you cant use any (blank) but you can use (blank)
novel therapies
Coumadin
What is the leading cause of cardioembolic stroke?
non-valvular A
Risk of intracranial bleeding w/ anticoagulation therapy increases with age after (blank) in non-valvular AF
75
What are the novel oral anticoagulants?
Pradaxa, ELiquis Xeralto
What is the major risk of pradaxa?
GI bleeding
What is the target INR for A fib?
2-3
There are a lot of (blank) with coumadin so you can get an increase in INR and get bleeding
drug interaxns
THe lower the INR the more quickly your blood (blank)
clots!
What happens if you are on coumadin (warfarin) and you eat a lot of leafy green high in vit K veggies?
you replace the vit K that coumadin is trying to deplete so you wil decrease INR and get more clotting
What is the CHADS2 score?
A fib stroke risk
What does CHADS2 stand for?
Congestive Heart failure Hypertension Age (greater than 75) Diabetes Strokes/TIA (counts as 2 points)
If your Chad scores is greater than (blank) then you need to be on a blood thinner (not aspirin)
1
T or F
coumadin is better than aspirin for stroke prevention
T
How is pradaxa cleared in the body?
kidney
If you have renal failure what NOAC drug cant you use?
Pradaxa (cuz cleared by kidney only)
Coumadin is reduces strokes by (blank)
65%
Risk of bleeding increases with (blank)
age
What 2 drugs are used when placing stents?
Thomboxane and ADP inhibitors
NOACs can all be used for (blank)
Atrial fib
What are the three NOAC that are factor 10a inhibitors?
Xeralto
Pradaxa
Eliquis
What do you pradaxa for?
AF pts (better than warfarin), PE and DVT
What is the INR for a mitral valve replacement
2.5-3.5
What is Ttr?
total therapeutic range
Use of (blank) can drive up INR
antiobiotics
How is eliquis cleared? so can you use this drug in renal failure?
stool liver and kidney
yes!
How long does it take for coumadic to get therapeutic?
4-6 days
Which drugs can be started right away?
Xareleto, pradaxa
What are the risks for DVT?
- long travel
- people w/ recent surgery
- hormone therapy
What is the most common cause of death in pregnant women?
DVT
What is the third leading cause of CV death (aside from MI and stroke)?
DVT
DVT can be caused from problems in what?
protein C, protein S, factor 5 ledien, antilupus AC
What is a pulseless electrical activity
when you see a perfect sinus rhythm but feel no pulse
What can PATCHHH tell you and what does it stand for?
Risk factors of PEA -PE -Acidosis -Tension pneumothorax -Cardiac tapenade -Hypovolemia -Hypoxemia -Hyperkalemia (these need to be fixed to save someone with PEA)
What are the symptoms of PE?
arrythmia, mild chest pain, tachycardia, dyspnea, low blood pressure
When someone comes nto the ER with a PE what do you start?
IV heparin drip
Why cant you use NOAC drugs for a PE in the ER?
because they have long half lifes that can be stopped immediately
When do you use subQ heparin?
for PREVENTION of PE or DVT
WHen can you give a PE patient novel drugs?
to send someone home after surgery
ALL patients need to be on (Blank) before being transferred to pradaxa
Lovinox
What is the dosage for Xaralto?
15mg 2 X day then 20mg 1/d after 20 days
What is the dosage for eliguis?
10mg/2xd for 7 days and then 5mg 2/x day after that (for about 3 months) for PE
