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Therapeutics 2 - Exam 4 > weber in-class > Flashcards

weber in-class Flashcards

1
Q

what drug is a direct thrombin inhibitor?

A

dabigatran etexilate (pradaxa)

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2
Q

what drugs are factor Xa inihibitors?

A

rivaroxaban (Xarelto)
apixaban (eliquis)
edoxaban (savaysa)

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3
Q

what drugs are NOACs/DOACs?

A

direct thrombin inhibitors
factor Xa inhibitors

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4
Q

what are the indications of NOACs/DOACs?

A

postop prophylaxis
non-valvular afib
DVT tx
PE tx
indefinite anticoag –> secondary prevention of recurrent DVT and/or PE
VTE prophylaxis

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5
Q

what NOAC/DOAC(s) can treat postop prophylaxis?

A

dabigatran –> hip only
rivaroxaban
apixaban

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6
Q

what NOAC/DOAC(s) can treat non-valvular afib?

A

all

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7
Q

what NOAC/DOAC(s) can treat DVT/PE?

A

all

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8
Q

what NOAC/DOAC(s) can be used for secondary prevention of recurrent DVT/PE

A

rivaroxaban
apixaban

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9
Q

what NOAC/DOAC(s) can treat VTE prophylaxis?

A

rivaroxaban

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10
Q

how should dabigatran be dosed for postop prophylaxis?

A

1 dose before surgery
hold day of surgery until after homeostasis
maintenance dose (2x pre-surgery) for a total duration of 28-35 days

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11
Q

what NOAC/DOAC is used in hip replacement only?

A

dabigatran

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12
Q

when should a small dose of apixaban be considered in afib?

A

need 2 of the following:
over 80 yos
body weight under 60kg
SrCr greater than 1.5mg

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13
Q

when is edoxaban not recommended in afib?

A

when CrCl is greater than 95 mL/min and under 15 mL/min

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14
Q

what NOAC/DOAC(s) require parenteral anticoagulation for DVT/PE tx?

A

dabigatran and edoxaban
requires 5-10 days

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15
Q

how is rivaroxaban dosed in DVT/PE tx?

A

start out at 15mg BID x3 days
then 20mg qd

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16
Q

how is apixaban dosed in DVT/PE tx?

A

start out at 10mg BID x7days
then 5mg BID

17
Q

what NOAC/DOAC(s) has weight based dosing in DVT/PE tx?

A

edoxaban
half the dose if under 60 kg

18
Q

when should a pt be switched to rivaroxaban and apixaban for secondary prevention?

A

after initial 6 months of tx

19
Q

what is the initial dose of warfarin?

A

5mg qd
healthy outpatients –> 10 mg x2d

20
Q

how should warfarin be overlapped?

A

UFH/LMWH/Xa for at least 5 days AND
until INR is therapeutics

21
Q

when is a recommended INR goal of 2.0-3.0?

A

prophylaxis of VTE
tx of VTE or PE
prevention of systemic embolism
antiphospholipid antibody syndrome
mechanical heart valve (aortic)

22
Q

when is a recommended INR goal of 2.5-3.5?

A

mechanical heart valve –> mitral, caged ball, high risk

23
Q

when should maintenance monitoring be adjusted?

A

after 2 consecutive INRs are within goal

24
Q

what are the 5Ds and the 2Bs?

A

drugs
diseases
doses
diet
drink
bruising/bleeding

25
Q

what is the main focus of the 5Ds?

A

if anything changes, the doctor needs to be notified!

26
Q

if the INR is suppose to be 2-3 and it reads as under 2.0, what should happen?

A

increase total weekly dose by 5-15%

27
Q

if INR is suppose to be 2-3 and it reads 3.1-3.5, what should happen?

A

decrease total weekly dose by 5-15%

28
Q

if INR is suppose to be 2-3 and it reads 3.5-4, what should happen?

A

hold 0-1 dose
decrease by 10-15%

29
Q

if INR is suppose to be 2-3 and it reads over 4, what should happen?

A

hold 0-2 doses
decrease by 10-15%

30
Q

when is bridging needed?

A

if patient is on warfarin and undergoing an invasive procedure

31
Q

how should bridging be carried out?

A

stop warfarin 5 days before surgery
give LMWH or UFH until procedure
resume warfarin 12-24 hours after surgery assuming adequate homeostasis

32
Q

when should LMWH be stopped before procedure?

A

only use for bridging
stop 24 hour before procedure

33
Q

when should UFH be stopped before procedure?

A

only IV use for bridging
stop 4-6 hours before procedure

34
Q

how should NOACs be bridged?

A

they should not be
just stop x hours before procedure based on CrCl and drug type

Therapeutics 2 - Exam 4 (9 decks)

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