Stroke and anticoagulation Flashcards
What is ischemic stroke treatment?
What is aspirins dose after stroke?
When is Mannitol CI’d?
Alteplase, must exclude hemorrhage before use. Can be administered within 3 hours of onset and BP must be <185/110. Dosing is 0-.9 mg/kg with max dose of 90. Dosing is different for MI and PE Major Bleeding risk, must keep BP <180/105 for 1st 24 hours after treatment.
162-325 mg within 24-48 hours after stroke.
Severe renal disease.
What is SAH hemorrhage treatment?
What is VTE prophylaxis dosing for UFH and other doses for things?
What are heparin’s side effects and notes?
NImodipine to prevent vasospasm. Do not administer IV due to death and serious life-threatening events. Watch for hypotension, can transfer to oral syringe. Label.
5000 units SC q8-12h. Binds to AT and inactivates factor 2a and Xa and prevents conversion of fibrinogen to fibrin. 80units/kg for treatment bolus followed by 18 units/kg/hr. Treatment of ACS/STEMI is 60 units/kg bolus and then 12 units/kg/hr. Use actual body weight.
Fatal medication errors, active bleed CI, apTT monitor(every 6 hours until range of 1.2-2.5 x control. Plateletes, Hgb, Hct. Antidote is protamine, unpredictable anticoagulant response, short half life, use correct dosage in neonates and HIT antibodies have cross-sensitivity with LMWH
What are the LMWH MOA and dosing?
What is enoxaparin(lovenox) side effects?
Binds to AT and inactivates Xa and 2a( Xa activity is much greater). Prophylaxis of VTE is 30 mg q12h or 40 mg sc daily, CrCl 30 mg sc daily. Treatment of VTE and UA/NSTEMI is 1 mg/kg Sc q12h, <30 is 1 mg/kg daily. USe actual bodyweight. STEMI is 30 mg IV plus 1 mg/kg dose, <30 30 mg IV bolus plus 1mg/kg. Patients >75 no bolus, CrCl<30 1 mg/kg daily no bolus.
Neuraxial anesthesia(epidural, spinal) risk of hematoma and subsequent paralysis BBW. History of HIT active major bleed CI, Plateletes, Hgb, Hct, SCr, Anti-Xa monitoring in pregnancy and peak anti-xa levels 4 hours post SC dose. does not requires anti-xa level monitoring in most cases. Antidote is protamine, do not expel air bubble from syringe.
