SPAF

Question 1

chadsvasc use for

Answer 1

determining stroke risk

Question 2

c in chadsvasc

Answer 2

chf +1

Question 3

h in chadsvasc

Answer 3

htn +1

Question 4

a in chadvasc

Answer 4

age ≥75 +2

Question 5

d in chadvasc

Answer 5

dm +1

Question 6

s in chadvasc

Answer 6

stroke/tia/thromboembolism +2

Question 7

v in chadvasc

Answer 7

vascular disease +1

Question 8

second ‘a’ in chadsvasc

Answer 8

age 65-74 +1

Question 9

what is hasbled used for

Answer 9

estimate bleeding risk

Question 10

H in hasbled

Answer 10

htn >160mmhg

Question 11

a in hasbled

Answer 11

abnormal function of renal (scr>200mmol/l) and liver (cirrhosis, bilirubin >2xULN)

+1 for each abnormality

Question 12

s in has bled

Answer 12

stroke hx +1

Question 13

b in hasbled

Answer 13

bleeding hx/predisposition +1

Question 14

e in hasbled

Answer 14

age >65 yo +1

Question 15

d in hasbled

Answer 15

drugs induced +1

Question 16

a in hasbled

Answer 16

alcohol (>8u per week) +1

Question 17

dabigatran dosing

Answer 17

150mg BD (110mg BD if >80yo, use of PGPi, high bleeding risk)
CI in CrCl <30 ml/min

Question 18

rivaroxaban dosing

Answer 18

20mg QD
Crcl 30-50ml/min: 15 mg QD

Question 19

Apixaban dosing

Answer 19

5mg
2.5mg BD if 2 factors: age>80y, weight <60kg, scr>133mmol/L

Question 20

Edoxaban dosing

Answer 20

60mg QD
30mg QD if (crcl 15-50, weight<60, concomitant verapamil, quinidine, dronedarone)

Question 21

how does alcohol affect warfarin

Answer 21

alcohol binge inhibits cyp450 enzyme,
chronic alcoholism induces cyp450

Question 22

how do antithyroid agents affect warfarin

Answer 22

reduce warfarin metabolism, cause increased levels of warfarin and hence over anticoagulation

Question 23

how does fever affect warfarin interaction

Answer 23

Fever results in increased INR

Question 24

how does antimicrobial affect warfarin interaction

Answer 24

disruption of gut bacteria, increased INR

Question 25

metronidazole

Answer 25

cyp2c9 inhibitor

Question 26

macrolides

Answer 26

cyp3a4 inducer

Question 27

rifampicin

Answer 27

cyp2c9, cyp2c19, cyp3a4 inducer

Question 28

amiodarone

Answer 28

cyp2c9, cyp1a2 inhibitor, increases drug concentration of warfarin in bloodstream

Question 29

ciprofloxacin

Answer 29

cyp3a4 inhibitor, cyp1a2 inhibitor

Question 30

phenytoin

Answer 30

cyp3a4, cyp2c9 inducer

Question 31

st john’s wort

Answer 31

cyp2c9, cyp2c19 inducer