Pradaxa

Question 0

Absolute bioavailability

Answer 0

6.5%

Question 1

Pradaxa inhibits

Answer 1

Free thrombin
Fibrin-bound thrombin
Thrombin-induced platelet aggregation

Question 2

Distribution of P

Answer 2

Low binding to plasma proteins - 34-35%

Question 3

Excretion

Answer 3

Eliminated primarily in the uncharged form in urine - 85%

Faecal excretion accounts for ~6%

Question 4

A missed dose may be taken up to …hrs prior to next does ?

Answer 4

6hrs

Question 5

Switching from VKAs to pradaxa

Answer 5

VKAs should be stopped. Pradaxa can be given as soon as INR is <2.0

Question 6

Switching from pradaxa to warfarin

Answer 6

Based on creatine clearance:
CrCl >50ml/min start warfarin 3days b4 discontinuing pradaxa.
CrCl 31-50ml/min, start W 2days b4 discontinuing pradaxa
CrCl 15-50ml/min, start W 1 day b4 discontinuing pradaxa
CrCl <15ml/min no recommendations can be made

Question 7

Reaches Peak level - Cmax

Answer 7

within 0.5-2hrs

Question 8

Half life

Answer 8

Mean - 12-17hrs
Elderly healthy volunteers - 12-14hrs
Patients undergoing major orthopaedic surgery - 14-17hrs