warfarin Flashcards
how many days before surgery should you stop warfarin
5 days
if no active bleeding and warfarin above 8 what do you do
stop warfarin and give oral vit K 1-5mg
repeat dose IV if sitll hgih restart when under 5 INR
if you have start warfarin at what INR can you restart it
under 5 INR
if no bleeding and INR between 5-8 hat do you do
withhold 1 or 2 doses of warfarin and reduce subsequent maintenance dose
in minor bleeding and INR either above 8 or 5-8 hat do
stop warfarin and give IV vitamin k 1-3mg
if major bleeding and INR baove rnage what do you do
stop warfarin and give IV vit k 5mg and a PCC
INR of 6.2 with af
withhold 2 doses of wararin and reduce subsequent maiantaince dose
first line of VTE nad stroke risk reduction in AF
DOAC
wrfarin targets in VTE and AF
2.5 and 2.5 unless recurrent VTE then 3.5
can causes skin necorsis
inhibitors of p450 enxymes increasing the INR so increasing bleedign time what drugs
ciprofloxacin, clarithymoycin and other macrolides, amiodarone and sodium valporate
Antibiotics
e.g. ciprofloxacin, clarithromycin/erythromycin
Amiodarone
Allopurinol
NSAIDs
SSRIs
Isoniazid
Sodium valproate
Omeprazole
Imidazole
e.g. ketoconazole, fluconazole
inducers of P450 enzyme
pehnytoin, carbamazepine, rifampicin and st john wort
Anti-epileptics
e.g. phenytoin, carbamazepine
Barbiturates
e.g. phenobarbitone
Rifampicin
St John’s wort
Smoking
Chronic alcohol intake
inducers of P450 enzyme
pehnytoin, carbamazepine, rifampicin and st john wort
Anti-epileptics
e.g. phenytoin, carbamazepine
Barbiturates
e.g. phenobarbitone
Rifampicin
St John’s wort
Smoking
Chronic alcohol intake
Which clinical scoring tool can be used to help determine the potential safety of anticoagulation use?
ORBIT - treatment of AF and stroke
Antithrombin III features
what factors
Antithrombin III normally inhibits factor IIa, Xa, IXa, and XIa. Antithrombin deficiency therefore increases the risk of thrombosis. Homozygosity causes death in utero and heterozygosity increases the risk of VTE 50-fold.
