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Cardio > VTE > Flashcards

VTE Flashcards

1
Q

UFH dose for VTE prophylaxis

A

5000 units sq q8h

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2
Q

UFH contraindications

A

history of HIT

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3
Q

when is UFH preferred

A

its lack of renal clearance makes it ideal for patients with AKI or CrCL <30 mL/min

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4
Q

enoxaparin dose for VTE prophylaxis

A

40 mg sq q24h or 30 mg sq q12h

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5
Q

renal dose adjustment enoxaparin for VTE prophylaxis

A

30 mg sq q24h

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6
Q

enoxaparin contraindications

A

AKI, HIT

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7
Q

dalteparin VTE prophylaxis dose

A

5000 units sq q24h

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8
Q

dalteparin contraindications

A

AKI, HIT

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9
Q

fondaparinux VTE prophylaxis dose

A

2.5 mg sq q24h

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10
Q

fondaparinux contraindications

A

CrCL <30 mL/min

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11
Q

when is fondaparinux preferred

A

patient with history of HIT

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12
Q

apixaban VTE prophylaxis dose for total hip arthroplasty

A

2.5 mg bid x 35 days

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13
Q

apixaban VTE prophylaxis dose for total knee arthroplasty

A

2.5 mg bid x 14 days

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14
Q

dabigatran VTE prophylaxis dose for total hip arthroplasty

A

110 mg once, then 220 mg daily x 35 days

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15
Q

rivaroxaban VTE prophylaxis dose in acute medical illness or total hip arthroplasty

A

10 mg daily x 35 days

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16
Q

rivaroxaban VTE prophylaxis dose for total knee arthroplasty

A

10 mg daily x 14 days

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17
Q

instances to avoid DOACs for VTE treatment

A

renal insufficiency, moderate to severe liver disease, significant drug-drug interactions (CYP3A4 inducers), CrCL < 30 mL/min)

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18
Q

apixaban dose for VTE treatment

A

10 mg bid x 7 days, then 5 mg bid x 3-6 months

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19
Q

dabigatran dose for VTE treatment

A

> 5 days of parenteral anticoagulation, then 150 mg bid x 3-6 months

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20
Q

edoxaban dose for VTE treatment

A

> 5 days of parenteral anticoagulation, then 60 mg daily x 3-6 months

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21
Q

rivaroxaban dose for VTE treatment

A

15 mg bid x 21 days, then 20 mg daily x 3-6 months

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22
Q

which DOACs require parenteral anticoagulation first for VTE treatment

A

dabigatran and edoxaban

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23
Q

UFH dose for VTE treatment

A

80 units/kg IV bolus, then 18 units/kg/hr initial rate titrated to aPTT or anti-Xa

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24
Q

enoxaparin dose for VTE treatment

A

1 mg/kg q12h (reduced to q24h if CrCL<30 mL/min)

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25
Q

dalteparin dose for VTE treatment

A

100 units/kg q12h

26
Q

fondaparinux dose for VTE treatment, <50 kg

A

5 mg daily

27
Q

fondaparinux dose for VTE treatment, 50-100 kg

A

7.5 mg daily

28
Q

fondaparinux dose for VTE treatment, >100 kg

A

10 mg daily

29
Q

which DOAC must be taken with food to facilitate absorption

A

rivaroxaban

30
Q

____ is the risk calculator used for medical patients

A

padua score

31
Q

____ is the risk calculator used for surgical patients

A

caprini score

32
Q

non-pharm VTE prophylaxis options

A

early ambulation, graduated compression stockings, intermittent pneumatic compression device, inferior vena cava (IVC) filters

33
Q

for high bleed risk patients, use ____ prophylaxis

A

mechanical

34
Q

when using pharm VTE prophylaxis, opt for ___

A

low dose

35
Q

for medical patients when pharm prophylaxis is used, ____ is preferred

A

LMWH

36
Q

for orthopedic surgery patients when pharm prophylaxis is used, _____ is preferred

A

DOAC

37
Q

for other major surgery patients when pharm prophylaxis is used, _____ is preferred

A

UFH or LMWH

38
Q

lab findings in DVT diagnosis

A

D-dimer elevation

39
Q

D-dimer is a product of _____

A

fibrin degradation

40
Q

non-invasive testing for DVT diagnosis

A

doppler ultrasonography

41
Q

invasive testing for DVT diagnosis

A

contrast venography

42
Q

lab findings in PE diagnosis

A

d-dimer elevation

43
Q

other ways to diagnose PE

A

ECG, chest xray, echo

44
Q

invasive testing for PE diagnosis

A

CT pulmonary angiography, ventilation/perfusion scan

45
Q

PE subtypes describe ____

A

the effect on the body, not the size of the clot

46
Q

massive PE

A

high risk, hemodynamic compromise, hypotension (SBP <90), may be candidates for thrombolytic therapy

47
Q

submassive PE

A

intermediate risk, without hemodynamic stability, evidence of right ventricular strain, positive cardiac biomarkers (troponin, BNP)

48
Q

non-massive PE

A

low risk

49
Q

for uncomplicated DVT and low-risk PE, what is preferred

A

outpatient, DOAC

50
Q

good DOAC candidates

A

clinically stable, CrCL>30 mL/min, no drug-drug interactions

51
Q

not good DOAC candidates

A

renal insufficiency, moderate to severe liver disease, significant drug interactions (CYP3A4 inducers)

52
Q

for limb-threatening DVT and intermediate to high risk PE, _____ is preferred

A

hospital admission and parenteral therapy

53
Q

advantages for DOACs in VTE

A

avoids parenteral therapy, predictable PK/PD effects, fixed dosing, similar or better efficacy with less major bleeding

54
Q

how to bridge to warfarin from parenteral anticoagulation

A

bridge until INR >2 on 2 consecutive readings 24 hours apart, minimum total overlap of 5 days

55
Q

how to bridge to DOAC from UFH

A

may discontinue infusion and give oral med simultaneously

56
Q

how to bridge to DOAC from LMWH or fondaparinux

A

give the oral dose when the next injection would have been due

57
Q

when is warfarin actually preferred

A

patients with renal insufficiency or antiphospholipid antibody syndromes

58
Q

why does warfarin have a delayed anticoagulation effect

A

it doesn’t influence existing clotting factors, its onset is limited by decreased production of new clotting factors

59
Q

things to note when using warfarin for VTE

A

frequent monitoring is required, goal INR 2-3 for most, drug/food interactions influence dose

60
Q

VTE treatment duration

A

3-6 months unprovoked, indefinite for unprovoked

61
Q

apixaban dose for ongoing secondary prevention/risk reduction

A

2.5 mg bid

62
Q

rivaroxaban dose for secondary prevention/risk reduction

A

10 mg daily

Cardio (26 decks)

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