Lecture 13: Anticoagulation Drugs Flashcards
How long should anticoagulation therapy be administered in pt with unprovoked DVT/PE?
At least 3 months; consider indefinite if bleeding allows, use aspirin
What is recommended length of anti-coagulant therapy in pt that had a cancer related DVT/PE?
As long as cancer is active
What are 4 factors that place pt in high-risk category post-operatively?
- Recent major orthopedic surgery
- Abdominal/pelvic cancer surgery
- Spinal cord injury or major trauma within 90 days
- ≥3 intermediate risk factors
What are 2 factors that place pt in low-risk category post-operatively?
- Minor procedure in age <40 without other risk factors
- Ambulatory with expected length of stay <24 hrs or minor surgery
What are the 4 uses of LMWH (enoxaparin) post-operatively, including frequency of dosing and length of use?
- Most medical pt’s and critical care pt’s
- Many surgical pt’s (4 weeks in abdominal/pelvic cancer surgery)
- Many ortho pt’s (2x daily; 10-day minimum; post-joint replacement up to 1 month in high risk pt’s)
- Bariatric surgery (2x daily in this group)
What is Fondaparinux used for clinically and for how long?
- Many ortho pt’s –> 10 day minimum
- Post-joint replacement up to 1 month in high-risk pt’s
What is the indication for use of the DOAC’s, Rivaroxaban and Apixaban, including length of use?
- Ortho pt’s s/p THA or TKA
- Give for 12 days following total knee
- Give for 35 days following total hip
What is the indication for using the DOAC, Dabigatran, including length of use?
- Ortho pt’s s/p THA
- Give only if CrCl is >30 mL/min
What is the goal INR when using Warfarin in ortho pt’s and in which pt’s is it indicated + how long should it be used?
- Goal INR = 2.5; give for 10 days minimum
- High-risk pt’s s/p THA, TKA, or hip fractures consider up to 1 month of use