Medications Flashcards
Name 3 antiplatelet medications
Plavix
ASA
Aggrenox (dipyridamole 200mg/ASA 25mg
What antiplatelet medication is indicated for primary stroke prevention?
ASA
Which medications are indicated for secondary stroke prevention?
Aggrenox
Plavix
Are antiplatelet meds reversible?
No
How do antiplatelets work?
Decrease platelet aggregation
Name some anticoagulants
Coumadin Pradaxa a Dabigatran Factor Xa inhibitors - eliquis - xarelto
What is the reversal agents for Coumadin
Vite K - 24 hrs
FFP - 1-4 hrs
PCC - 10-15 min
Contraindications for anticoagulants
- Pregnancy
- Major bleeding disorders/tendencies
- Aneurysm
- pericarditis
- Endocarditis
- Active bleeding
Interactions of anticoagulants
Increases effects -herbals -amiodarone/dronedarine -ABX -antifungals -HIV meds -phenytoin -acute ETOH use Decreases effects -phenobarbital -carbamazepine -rifampin -foods/drugs w/ vite k -chronic ETOH use
What is the therapeutic INR range for Coumadin
2-3
How does Coumadin wrk and onset of action
Vite K antagonist
Onset 36-48 hrs
Antiplatelet interactions
- Increased bleeding risk when taken with anticoagulants
- NSAIDS
- Garlic, ginger
What is the indication for the anticoagulant dabigatran
Non-vascular afib and VTE treatment
What is the dosage of Pradaxa dabigatran
75-150mg BID
What is the mechanism of action for dabigatran
Direct thrombin inhibitor
Onset 1-3 hrs
Contraindications for dabigatran
Active bleeding
Known hypersensitivity
Mechanical prosthetic heart valve
Interactions of dabigatran
Increases effects: dronedarone, ketoconazole
Decreases effects: rifampin
What are reversal agents for dabigatran PRADAXA
- Praxbind - reverses ICH bleeding in 21 min
- PCC
- Dialyzable (50% of drug is removed in 4 hrs)
Indications for Xa inhibitor anticoagulants
Non-valvular afib
VTE treatment
Dosing for rivaroxaban Xarelto
15-20mg daily with evening meal
Dosing for Xa inhibitor apixaban Eliquis
5mg BID
- 5mg BID if 2 of the following:
- > 79 y/o
- wt >61 kg
- creat >1.4
Onset of action for
rivaroxaban Xarelto and apixaban Eliquis
Xarelto 2-4 hrs
Eliquis 3-4 hrs
Contraindications of factor Xa inhibitors
- Bleeding
- Known hypersensitivity
- Spinal procedure/puncture
- Mechanical heart valve
- Caution pregnancy
- Child-Pugh C (hepatic dz)
Interactions of factor Xa inhibitors
Increases effects:
-clarithromycin, EES, ketoconazole, fluconazole, ratinovir
Decreases effects:
- phenytoin, phenobarbital, carbamazepine, rifampin
Name some thrombolytics
Alteplase
Reteplase
Tenscteplase
Contraindications for thrombolytics
- INR >1.7
- Plt < 100,000
- LMWH in the last 24 hrs
- NOAC in last 48 hrs
