hemologic and immune pharmothereaputics: direct inhibit of factor Xa

Question 1

direct inhibitor of factor Xa moa

Answer 1

• provides anticoagulation selectivity and directly by inhibiting factor Xa to prevent formation of thrombin

Question 2

direct inhibitor of factor Xa therapeutic uses

Answer 2

• stroke prevention for people with atrial fibrillation
• post op DVT or PE
• prevention for hip/knee, treatment for DVT or PE unrelated to orthopedic sugery

Question 3

direct inhibitor of factor Xa antidote

Answer 3

andexnet afla

Question 4

direct inhibitor of factor Xa common med

Answer 4

rivaroxaban

Question 5

direct inhibitor of factor Xa complications

Answer 5

bleeding

- elevated liver enzymes and elevated bilirubin

Question 6

direct inhibitor of factor Xa contraindications

Answer 6

• allergy to rivaroxaban
• active bleeding
• severe kidney impairment
• moderate to severe liver impairment
• use cautiously in its taking anticoagulants, antiplatelts , fibrinolytics

Question 7

direct inhibitor of factor Xa interaction

Answer 7

• intraconzaole, ritonavir, democonazole (incrases rivaroxaban levels)
• amiodarone, quinidine, diltiazem, verapamil, ranolazine, macrolide antibiotics (can increase levels)
• rifampin, carbamazepine, phenytoin, st. johns wart (decrease levels)
• feverfew, garlic, ginger, glucosamine, ginkgo biloba, reseratrol, saw palmetto (increase risk of bleeding)

Question 8

direct inhibitor of factor Xa nursing implications

Answer 8

• administer tablets once a day at the same time, with or without food
• monitor hemoglobin, hematocrit, and liver and kidney function periodically during treatment
• monitor for s/s of internal bleeding
• be prepared to administer andexanet alfa for rivaroxaban toxicity

Question 9

direct inhibitor of factor Xa teaching implications

Answer 9

• take med as directed, same time each day
• report s/s of bleeding to provider
• do not take with alcohol or other the counter NSAIDS, herbal supplements

Question 10

direct inhibitor of factor Xa test labs: hemoglobin and hematocrit

Answer 10

• hemoglobin: normal levels 12-18 g/dl

- hematocrit- normal levels 38%- 54%

Question 11

if H&H is lower

Answer 11

problem- bleeding somewhere

Question 12

total billrubin

Answer 12

normal: .3- 1.2 mg/dl

Question 13

BUN

Answer 13

6-20 mg/dl

Question 14

liver enzymes:

AJT-

Answer 14

normal 7-46 v/l

Question 15

Liver enzymes:

Answer 15

ALT- normal 10-30 iv/ml