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B&R Final > Propylaxis/Treatmetn of Thromboembolic Disease > Flashcards

Propylaxis/Treatmetn of Thromboembolic Disease Flashcards

1
Q

Define anticoagulants

A

Prevent clot formation and extension

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2
Q

Anticoagulant Examples

A

Warfarin, LMWH, fondaparinux

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3
Q

Antiplatelet drugs examples

A

Aspirin

Clopidogrel

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4
Q

Thrombolytic Agents

A

Alteplase
Reteplase
Tenecteplase

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5
Q

When do you give prophylaxis?

A

Medical/Surgical
Stroke
Valve replacement

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6
Q

When do you treat?

A

Acute VTE

Prevent recurrent VTE

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7
Q

Patient RF for prophylaxis treatment

A

CHF, COPD, stroke, sepsis, previous VTE, ICU, thrombophillia

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8
Q

Medical pts who need prophylaxis treatment

A

> 40
Limited mobility >3d
1 RF
ICU with no mobility

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9
Q

SCORE IT

A 
Surgery
Cancer/CV
Obesity
Respiratory Failure
Elderly

Infxn/Inflammatory/Immobile/ICU
Trauma/thromboembolism

Each = 1 point

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10
Q

Low Risk

A

</=1 OR

Minor surgery

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11
Q

Moderate Risk

A

Score of 2
OR Major surgery
AND >40 yo

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12
Q

High Risk

A

Score of 3/4 OR
Over 40
AND major surgery or heart infection and additional RF

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13
Q

Very High Risk

A

Score >/= 5 OR

Major surgery + >40 + history of TE, hip fracture or joint procedure, stroke, malignancy, or additional RF

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14
Q

Low Risk Treatment

A

Early and aggressive ambulation

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15
Q

Moderate Risk Treatment

A

Low dose UFH or LMWK or Fondaparinux OR Mechanical thromboprophylaxis

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16
Q

High Risk Treatment

A

Low dose UFH or LMWK or Fondaparinux OR warfarin or rivaroxaben or Mechanical thromboprophylaxis

17
Q

Mechanical prophylaxis

A

Intermittent pneumatic compression
Graduated compression stockings
Venous foot pump

18
Q

Low dose UFH dose

A

5000u SQ Q8H

19
Q

LMWH Enoxaparin Dose

A

40 mg SQ daily
30 mg if knee or CrCl <30
Increase dose by 30% if over BMI 40

20
Q

Dalteparin Dose

A

5000uor 2500u SQ QD

21
Q

Fondaparinux Dose

A

2.5 mg SQ QD unless under 50kg

22
Q

Rivaroxaban dose

A

10 mg PO QD hip or knee

Watch CrCl <30

23
Q

Apixaban dose

A

2.5 mg BID beginning 12-24 post-op for 35 days

Watch CrCl <30

24
Q

Moderate risk Duration

A

Until ambulatory

25
Q

High risk duration

A

10-35 days for orthopedic surgery OR until ambulatory

26
Q

Safety Monitoring

A

Platelets
S/Sx of bleeding
INR for warfarin
Anti-Xa for LMWH

27
Q

Therapeutic Dosing When?

A

When a thrombus is present
DVT, PE, atrial fibrillation, heart valve
Stroke (CHADS2 score)
Heart valve patients

28
Q

Stroke CHADS2 Score

A 
CHF
HTN
Age>75
DM Stroke
TIA
Score of 1-2 or greater = full dose
29
Q

Pt Assessment Treatment Consideration

A 
Renal or hepatic disease
Alcoholism
Obesity or underweight
Bleeding or fall risk
Ability to self-inject
Ability to follow up for lab monitoring
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B&R Final (9 decks)

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