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PHM601 UB Pharmacy > Venous Thromboembolism > Flashcards

Venous Thromboembolism Flashcards

1
Q

Virchow’s Triad

A

Hypercoagulable State
Vascular Injury
Circulatory Stasis

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2
Q

Types of venous clots/VTEs

A

Pulmonary embolism
Deep vein thrombosis

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3
Q

Risk factors causing a hypercoagulable state

A

Malignancy
Pregnancy
Inflammatory state
Factor V Leiden
Protein C/S deficiency
Oral contraceptives

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4
Q

Risk factors causing circulatory stasis

A

Hospitalization
Surgery
Obesity
Long distance travel

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5
Q

Risk factors causing vascular injury

A

Orthopedic surgery
Trauma
Venous catheters
Smoking

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6
Q

Risk factors contributing to multiple components of Virchow’s Triad

A

Age
History of VTE

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7
Q

Scoring tool used in hospitalized patients to determine need for VTE prophylaxis

A

PADUA Score

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8
Q

PADUA score that indicated thromboprophylaxis intitiation

A

/> 4

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9
Q

Heparin for VTE prophylaxis dose (BMI < 40 kg/m^2)

A

5,000 units q8-12h SQ

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10
Q

Heparin for VTE prophylaxis dose (BMI /> 40 kg/m^2)

A

7,500 units q8-12h SW

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11
Q

Enoxaparin for VTE prophylaxis dose

A

30 units BID or 40 units QD SQ

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12
Q

Anticoagulants that can be used in high-risk outpatients with cancer (Khorana score /> 2)

A

apixaban
rivaroxaban
LMWH

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13
Q

Anticoagulants that can be used for thromboprophylaxis in low-risk patients with multiple myeloma receiving thalidomide- or lenalidomide- based regimens with chemotherapy

A

aspirin or LMWH

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14
Q

Anticoagulants that can be used for thromboprophylaxis in higher-risk patients with multiple myeloma receiving thalidomide- or lenalidomide- based regimens with chemotherapy

A

LMWH

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15
Q

DVT signs and symptoms

A

Unilateral leg pain and/or swelling and warmth
Positive Homan’s Sign
Elevated D-dimer

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16
Q

VTE with no cancer treatment options (4)

A

dabigatran, rivaroxaban, apixaban, edoxaban
(over warfarin)

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17
Q

VTE and no cancer not treated with first line options (dabigatran, rivaroxaban, apixaban, edoxaban) treatment choice (1)

A

warfarin (over LMWH)

18
Q

Prophylaxis agent indicated when patients with an unprovoked proximal DVT or PE are stopping anticoagulant therapy

A

aspirin

19
Q

Anticoagulant treatment duration for proximal DVT or PE

A

3 months

20
Q

Anticoagulant treatment duration for unprovoked VTE and low-moderate bleeding risk

A

extended therapy (no scheduled stop date)

21
Q

Anticoagulant treatment duration for unprovoked VTE and high bleeding risk

A

3 months

22
Q

Treatment for acute isolated distal DVT

A

serial imagining of the deep veins for 2 weeks (unless severe symptoms or risk factors)

23
Q

Anticoagulant options for acute distal DVT

A

dabigatran, rivaroxaban, apixaban, edoxaban

24
Q

When is anticoagulation indicated in patients with acute isolated distal DVT managed with serial imaging

A

if the thrombus extends

25
Q

Initial anticoagulant therapy options in patients with cancer being treated for a DVT

A

LMWH, UFH, fondaparinux, rivaroxaban, apixaban

26
Q

Long-term anticoagulant therapy options in patients with cancer being treated for a DVT

A

LMWH, edoxaban, rivaroxaban

27
Q

Duration of anticoagulant therapy in patients with cancer being treated for DVT

A

at least 6 months

28
Q

Low risk PE definition

A

Not meeting other criteria

28
Q

Signs and symptoms of a pulmonary embolism (PE)

A

Couch, chest pain/tightness, SOB
Dyspnea, tachycardia, tachypnea
Elevated D-dimer

29
Q

Massive PE definition

A

Systolic BP < 90 mmHg or decrease of 40 mmHg from baseline,
Requiring vasopressors,
Pulseless

29
Q

Submassive PE definition

A

Right ventricular strain: on ECHO, (+) troponin, (+) BNP

30
Q

Low risk PE treatment strategy (1)

A

therapeutic anticoagulation

31
Q

Submassive PE treatment strategies (3)

A

Anticoagulation, thrombectomy, or catheter-directed thrombolytics
then anticoagulation

32
Q

Massive PE treatment strategy

A

IV thrombolytics then therapeutic anticoagulation

33
Q

Thrombolytic agents (3)

A

Alteplase
Reteplase
Tenecteplace

34
Q

Mechanism of action of thrombolytics

A

activate plasminogen -> plasmin and degrade fibrin clots

35
Q

Medications that can be used in catheter directed thrombolytics (CDT) (2)

A

heparin
alteplase

36
Q

Anticoagulants preferred in PE treatment in patients with no cancer (4)

A

dabigatran
rivaroxaban
apixaban
edoxaban

37
Q

Second line option for PE treatment in patients with no cancer (1)

A

warfarin

38
Q

Duration of anticoagulant treatment in patients with a PE

A

3 months

39
Q

Duration of anticoagulation therapy in patients with active cancer and PE

A

extended therapy (no scheduled stop date)

PHM601 UB Pharmacy (6 decks)

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