VTE 2

Question 1

Low INR means: ___ bleeding risk

Answer 1

low

might clot :(

Question 2

High INR means ___ bleeding risk

Answer 2

High

might bleed out :(

Question 3

Warfarin Protocol - INR goal 2.0-3.0

INR < 2.0
- increase by ___ - ___%

Answer 3

5-15%

Question 4

Warfarin Protcol - INR goal 2.0-3.0

INR 3.1-3.5
- decrease by ___ - ___ %

Answer 4

5-15%

Question 5

Warfarin Protcol - INR goal 2.0-3.0

INR 3.5-4.0
- hold ___ - ___ dose and/or
- decrease by ___ - ___ %

Answer 5

• 0-1
• 10-15%

Question 6

Warfarin Protcol - INR goal 2.0-3.0

INR > 4.0
- hold ___ - ___ dose and/or
- decrease by ___ - ___ %

Answer 6

• 0-2
• 10-15%

Question 7

Steps of Adjusting Warfarin

1) evaluate if INR is low or high
2) add up ___ dose
3) spread 2 adjustments. Preferred days ___ and ___
4) add a dose adjustment in the middle of those. Preferred day: ___
5) if INR is still high/low, we will flip flop the adjustments to days ___, ___, ___ , and ___

Answer 7

• weekly
• monday, friday
• wednesday
• tuesday, thursday, saturday, sunday

Question 8

Invasive procedures

“Bridging therapy” - have to stop therapy due to upcoming procedure
- stop warfarin ___ days before surgery
- give ___ or ___ until procedure
- stop ___ 24 hours before procedure
- stop ___ 4-6 hours before procedure
- resume warfarin ___ - ___ hours after surgery assuming adequate ___

Answer 8

• 5
• UFH, LMWH
• LMWH
• IV UFH
• 12-24
• hemostasis

Question 9

Invasive procedure - when to stop NOACs

the lower the CrCl, the ___ you should stop the drug bc it stays in the body longer.

Answer 9

sooner