Lecture 13: Anticoagulation Drugs Flashcards

1
Q

How long should anticoagulation therapy be administered in pt with unprovoked DVT/PE?

A

At least 3 months; consider indefinite if bleeding allows, use aspirin

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2
Q

What is recommended length of anti-coagulant therapy in pt that had a cancer related DVT/PE?

A

As long as cancer is active

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3
Q

What are 4 factors that place pt in high-risk category post-operatively?

A
  • Recent major orthopedic surgery
  • Abdominal/pelvic cancer surgery
  • Spinal cord injury or major trauma within 90 days
  • ≥3 intermediate risk factors
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4
Q

What are 2 factors that place pt in low-risk category post-operatively?

A
  • Minor procedure in age <40 without other risk factors
  • Ambulatory with expected length of stay <24 hrs or minor surgery
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5
Q

What are the 4 uses of LMWH (enoxaparin) post-operatively, including frequency of dosing and length of use?

A
  1. Most medical pt’s and critical care pt’s
  2. Many surgical pt’s (4 weeks in abdominal/pelvic cancer surgery)
  3. Many ortho pt’s (2x daily; 10-day minimum; post-joint replacement up to 1 month in high risk pt’s)
  4. Bariatric surgery (2x daily in this group)
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6
Q

What is Fondaparinux used for clinically and for how long?

A
  • Many ortho pt’s –> 10 day minimum
  • Post-joint replacement up to 1 month in high-risk pt’s
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7
Q

What is the indication for use of the DOAC’s, Rivaroxaban and Apixaban, including length of use?

A
  • Ortho pt’s s/p THA or TKA
  • Give for 12 days following total knee
  • Give for 35 days following total hip
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8
Q

What is the indication for using the DOAC, Dabigatran, including length of use?

A
  • Ortho pt’s s/p THA
  • Give only if CrCl is >30 mL/min
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9
Q

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?

A
  • 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
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