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UBSPPS PHM601 Cardio/Renal Pharmacotherapeutics > VTE > Flashcards

VTE Flashcards

1
Q

Treatment for acute isolated distal DVT of the leg without severe symptoms

A

Serial imaging x 2 weeks

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2
Q

Treatment for acute isolated distal DVT of the leg without severe symptoms

A

Anticoagulation

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3
Q

List the 3 fibrinolytics

A

Alteplase (tPA)
Reteplase
Tenecteplase

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4
Q

Fibrinolytic most specific for fibrin bound plasmin

A

Tenecteplase

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5
Q

Fibrinolytic least specific for fibrin bound plasmin

A

Alteplase

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6
Q

Medications used for catheter directed thrombolysis (CDT)

A

Heparin and alteplase

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7
Q

What are the two clinical pearls associated with Argatroban?

A

about 85% hepatobiliary elimination
will elevate INR

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8
Q

True or False: you can transition from a DTI directly to a DOAC

A

True

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9
Q

When is it appropriate to change from a DTI to warfarin?

A

after the platelets level is above 150,000

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10
Q

If a patient is on Bivalirubin and has a PTT at baseline and an INR below range what is the proper next step?

A

Restart the drip

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11
Q

What is the INITIAL treatment recommendation for a patient with high/strong cancer quality and evidence?

A

initial anticoagulation can be enoxaparin, heparin, fondaparinux, or rivaroxaban.

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12
Q

Is LMWH (enoxaparin) or heparin the preferred parenteral anticoagulant for high/strong cancer patients?

A

LMWH is preferred over UFH for initial 5-10 days

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13
Q

What is the LONGTERM treatment recommendation for a patient with high/strong cancer quality and evidence?

A

LMWH, edoxaban, or rivaroxaban for at least 6mon (improved efficacy over Vit K antagonists)

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14
Q

What is the treatment recommendation for a patient with low/weak cancer quality and evidence?

A

Offer anticoagulation after 6mon to specific patients who have active cancer (ie: those with metastatic disease or receiving chemotherapy)

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15
Q

What are the most commonly affected veins in proximal DVT?

A

Popliteal and superficial femoral vein

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16
Q

What is provoked DVT?

A

A DVT caused by a known event

17
Q

What are common causes of provoked DVT?

A

Long distance travel Surgery Hospitalization

18
Q

What is unprovoked DVT?

A

A DVT that has no identifiable cause

19
Q

In patients with VTE and no cancer, what do we use for treatment?

A

Dabigatran, rivoroxaban, apixaban, or edoxaban

20
Q

In patients with VTE and no cancer, but not treated with dabigatran, rivoroxaban, apixaban, or edoxaban, what do we use for treatment?

A

Warfarin

21
Q

In patients with unprovoked proximal DVT/PE who are stopping anticoagulant therapy, what do we use for treatment?

A

Aspirin (if patient does not have CIs to aspirin)

22
Q

How long is anticoagulant therapy used in patients with proximal DVT/PE?

A

3 months

23
Q

How long is anticoagulant therapy used in patients with unprovoked VTE and a low to moderate bleeding risk?

A

Extended period of time (no scheduled stop date)

24
Q

How long is anticoagulant therapy used in patients with unprovoked VTE with a high bleeding risk?

A

3 months

25
Q

How long is anticoagulant therapy used in patients with a DVT in the leg or PE and also have active cancer?

A

Extended period of time (no scheduled stop date)

26
Q

What are the 4 recommended anticoagulation agents for initial DVT treatment in cancer patients?

A

LMWH, UFH, Fondaparinux, Rivaroxaban

27
Q

Site of cancer: stomach, pancreas

A

+2

28
Q

Site of cancer: lung, lymphoma, gynecologic, bladder, testicular, renal

A

+1

29
Q

Prechemotherapy platelet count ≥ 350,000

A

+1

30
Q

Hemoglobin < 10g/dL or use red cell growth factors

A

+1

31
Q

Prechemotherapy leukocyte count > 11,000

A

+1

32
Q

BMI ≥ 35

A

+1

33
Q

What treatment is offered to high-risk outpatients with cancer?

A

Thromboprophylaxis with Apixaban, Rivaroxaban, LMWH

34
Q

High risk outpatients with cancer has a Khorana score of ____

A

≥ 2

35
Q

What is the caveat of providing thromboprophylaxis with apixaban, rivaroxaban, LMWH to high-risk outpatients with cancer?

A

Provided that there are no significant risk factors for bleeding and no drug interactions.

UBSPPS PHM601 Cardio/Renal Pharmacotherapeutics (32 decks)

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