Info Flashcards
Bridging as xarelto
Xarelto eliminates the need for bridging with parent earl heparin or low molecular weight heparin to oral therapy
-also requires no routine monitoring of INR or other coagulation parameters required
What is Xarelto’s indications?
- Reducing the risk of stroke in nonvalvular afib
- treatment of DVT
- treatment of PE
- reducing the risk of recurrence of dvt and pe following initial 6 months treatment for dvt and or pe
- prophylaxis of dvt which may lead to pe in pts undergoing knee replacement
- prophylaxis of dvt which may lead to pe in people undergoing hip replacement
Dosing for Reducing risk for stroke in nonvalvular Af
20 mg QD pts with crcl >50ml/min
: with evening meal or
15mg QD pts with crcl 15-50 ml/min with evening meal
Dosing for treatment of DVT and PE
15 mg bid with food for first 21 days, on day 22, 20mg QD with food at approximately same time for the remaining treatment
Reduce risk of recurrent DVT and PE
20 mg once daily with food at appx the same time each day
DVT which may lead to PE after knee or hip replacement
10 mg once daily
Knee 12 days Hip 35 days
Initial dose should be taken at least 6-10 hours after surgery once hemp stasis has been established
Switching to xarelto from warfarin
Stop warfarin and start xarelto when INR is <3
Switching to xarelto from UFH
Stop the infusion and start xarelto at the same time
Switching from other anticoagulants to xarelto
Start xarelto 0-2 hours prior to the next scheduled evening admin of the other anticoagulant
Switching dr xarelto to warfarin
One approach is to stop xarelto and start parenteral anticoagulant and warfarin at time of next scheduled xarelto dose
Fr xarelto to other anticoagulants
Stop xarelto and start other anticoagulant when the next dose of xarelto would have been given
Xarelto washout
Quick washout 24-36 hrs
Xarelto onset of action
Xarelto has a quick onset of action; 2-4 hrs to Cmax
What is the half life of Xarelto?
Half life of Xarelto is 5-9 hours in healthy subjects 20-45 yrs and 11-13hrs in the elderly
What is Afib?
Abnormal heart beat where heart rhythm is fast and irregular
Part of heart cannot contract in an organized manner and cannot pump enough blood to meet the body’s needs
What are some symptoms of AFIB?
Pulse is rapid Confusion Fatigue Dizziness Shortness of breath
Normal pulse rate?
60-100 but in AFIB may be 100-175 Tests used Event monitor Holster monitor (24 hr test) Treatment cardio version, drugs through veins
What is a DVT?
Formation of a blood clot in the deep vein in the legs predominantly
Symptoms are: pain, swelling, redness, warmth in the leg
What is a PE?
Caused by the detachment of the clot from the leg as a result of the DVT and it travels to the lungs
