VTE Prophylaxis Flashcards
Two types of VTE?
deep vein thrombosis (DVT) pulmonary embolism (PE)
__ is the first Sx in about 25% of people who have a PE
sudden death
3 parts of Virchow’s triad?
- hypercoagulable state
- vascular wall injury
- circulatory stasis
Which guideline suggests prophylactic parenteral anticoagulation over no anticoagulation in acutely ill medical pts?
a. ASH 2018
b. CHEST 2012
a. ASH 2018
What PADUA score is associated with low VTE risk?
<=4
What PADUA score is associated with high VTE risk?
> 4
The Caprini VTE test is much more in depth than the PADUA prediction score
a. true
b. false
a. true
What diagnostic test is used for DVT?
ultrasound
What diagnostic test is used for PE?
CT
D dimer can be used to rule out PE
a. true
b. false
a. true
if D dimer is low very rarely will pt have a clot
__ is an indirect Xa inhibitor only
a. enoxaparin
b. heparin
a. enoxaparin
__ is an indirect IIa, Xa inhibitor
a. enoxaparin
b. heparin
b. heparin
Standard LMWH/enoxaprin dose?
40mg SubQ daily
Lovenox
Standard UFH dose?
5000 units SQ q8-12hrs
Which has a longer half life, enoxaparin or heparin?
enoxaparin
5-7 hrs vs 1-2hrs for heparin
RR has now been in the hospital for 48 hours. He has become less mobile, and the team wants to start him on VTE prophylaxis in order to prevent any complications to his hospital stay. His PADUA risk score is 5 indicating pharmacologic therapy. Based on what we have learned so far, what is the best chemoprophylaxis agent for RR.
a. dalteparin 2500 units BID
b. enoxaparin 40mg daily
c. enoxaparin 100mg BID
d. heparin IV drip
b. enoxaparin 40mg daily
What test is used to monitor heparin?
activated partial thromboplastin time
aPTT
also CBC
- hb/hematocrit
- platelets
Hospitals rarely perform anti factor Xa assay for enoxaprin monitoring.
a. true
b. false
a. true
expensive
CBC
- hgb/hematocrit
- platelets
What is heparin dose for obesity with BMI > 40?
7500 units TID
What is enoxaparin dose for obesity with BMI > 40?
40mg BID or 0.5 mg/kg/day
What is heparin dose for low body weight < 50kg?
5000 units BID ro TID
What is enoxaparin (Lovenox) dose for low body weight < 50kg?
30mg daily
No renal adjustment is necessary for heparin in pts with renal dysfunction.
a. true
b. false
a. true
What is dose of enoxaparin (Lovenox) in pts with renal dysfunction with CrCl < 30?
30mg daily or switch to heparin
Extended VTE prophylactic therapy may be required for the duration of cancer/therapy
a. true
b. false
a. true
Trauma pts who underwent major orthopedic surgery need what dose of Lovenox (enoxaparin)?
30mg every 12hrw
A pt has a BMI of 42. Which is the best VTE prophylaxis?
a. dalteparin 2500 units BID
b. dalteparin 5000 units TID
c. enoxaparin 40mg daily
d. enoxaparin 40mg BID
d. enoxaparin 40mg BID
