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PHAR 402 > Exam 3 old > Flashcards

Exam 3 old Flashcards

1
Q

Which NOAC causes increased GI bleeding?

A

apixaban

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2
Q

Which NOAC has an antidote and what is it called?

A

dabigatran, antidote is idarucizumab

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3
Q

What are the investigational NOAC antidotes? (2)

A

andexanet alfa

ciraparantag

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4
Q

Which investigational NOAC is factor Xa specific and which one is universal?

A

Xa: andexanet alfa

universal: ciraparantag

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5
Q

Which NOACs do not use starter injectable anticoag?

A

rivaroxaban

apixaban

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6
Q

What are the inhibitors and inducers of NOAC DDI?

A

inHIBitors: dronaderone, ketoconazole, diltiazem

inDUCers: rifampin, St. John’s wort

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7
Q

Which NOAC is heavily reliant on renal CL?

A

dabigatran, but all are renally metabbed to some extent

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8
Q

Which NOAC is dialyzable?

A

dabigatran

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9
Q

Which NOAC needs to be taken with food?

A

rivaroxaban

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10
Q

Which NOACs require an injectable lead-in anticoag?

A

dabigatran

edoxaban

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11
Q

Which NOACs are indicated for orthopedic surgery?

A

rivaroxaban

apixaban

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12
Q

What is the dosing of apixaban in prevention of thrombus in atrial fibrillation?

A

5 mg po BID

IF two or more of the following are present 2 mg po BID

≥ 80 years weight

≤ 60 kg

CrCL≥1.5mg/dL

on strong dual inhibitors of 3A4 or p-gp

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13
Q

What is the dosing of dabigatran in prevention of thrombus in atrial fibrillation with and without p-gp inhibitors?

A

CrCL > 30 mL/min: 150 mg BID

CrCL 15-30 mL/min: 75mg BID

CrCL 30-50 mL/min with p-gp inhibitors dronaderone or ketoconazole: 75 mg BID

CrCL < 30 mL/min with p-gp inhibitors: avoid

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14
Q

What is the dosing of edoxaban in prevention of thrombus in atrial fibrillation?

A

CrCL 50-95 mL/min: 60 mg QD

CrCL 15-50 mL/min: 30 mg QD

CrCL > 95 mL/min: contraindicated

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15
Q

What is the dosing of rivaroxaban in prevention of thrombus in atrial fibrillation?

A

CrCL ≥ 50 mL/min 20 mg QD with evening meal

CrCL 15-50 mL/min 15 mg QD with evening meal CrCL

CrCL < 15 mL/min: not recommended

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16
Q

What is the dosing of apixaban in VTE prevention in hip or knee replacement?

A

2.5 mg BID

17
Q

What is the dosing of apixaban in treatment of VTE?

A

10 mg BID x7D then 5 mg BID

after 6 months: 2.5 mg BID

18
Q

What is the dosing of dabigatran in treatment of VTE with and without p-gp inhibitors?

A

CrCL > 30 mL/min: 150 mg BID after 5-10 days of parenteral anticoag

CrCL < 30 mL/min or dialysis: avoid

CrCL < 50 mL/min with p-gp inhibitors: avoid

19
Q

What is the dosing of edoxaban in treatment of VTE with and without p-gp inhibitors?

A

60 mg QD after 5-10 days of parenteral anticoag

CrCL 15-50 mL/min, < 60 kg, and use of certain p-gp inhibitors: 30 mg QD

20
Q

What is the dosing of rivaroxaban in VTE prevvention in hip or knee replacement?

A

CrCL ≥ 30 mL/min: 10 mg QD

CrCL < 30 mL/min: avoid

21
Q

What is the dosing of rivaroxaban in the treatment of VTE?

A

CrCL ≥ 30 mL/min: 15 mg BID x21D then 20 mg QD

CrCL < 30 mL/min: avoid

22
Q

Which NOAC cannot be crushed or taken out of the original bottle?

A

dabigatran

23
Q

How should switching between LMWH and NOAC be done both way?

A

start and stop at next scheduled dose both ways

24
Q

How should UFH and NOAC be switched both ways?

A

stop UFH, start NOAC immediately

stop NOAC, start UFH at next scheduled dose

25
Q

How should warfarin and NOAC be switched both ways?

A
  • warfarin to NOAC
    • stop warfarin, start NOAC when INR < 2
  • NOAC to warfarin
    • start warfarin and overlap with NOAC until INR > 2
      • stop NOAC, start LMWH and warfarin at next scheduled dose, stop LMWH when INR > 2
26
Q

What is the test that should be used for dabigatran?

A

aPTT

27
Q

What is the test that should be used for factor Xa inhibitors?

A

PT

28
Q

What is the ductus arteriosus?

A

structure in fetus which allows blood to bypass lungs from pulmonary arteries to aorta

29
Q

What is the ductus venosus?

A

structure in fetus which allows blood to bypass the liver from the placenta to the heart

30
Q

What is the foramen ovale?

A

opening between RA and LA in fetus which allows blood to pass from RA to LA

31
Q

What is another name for left to right shunts?

A

acyanotic shunts

32
Q

What are the three different kinds of left to right shunts?

A

ventricular septal defect

atrial septal defect

patent ductus arteriosus

33
Q
A

PHAR 402 (2 decks)

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