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24 Cards in this Set
- Front
- Back
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Heparin
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Unfractionated heparin
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Heparin MOA
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Binds to antithrombin III and inactivates thrombin (Factor IIa), Factor Xa, and IXa, XIa, XIIa
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Enoxaparin
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Lovenox
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Enoxaparin MOA
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Bind to antithrombin III and inhibit Xa much greater than IIa
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Fondaparinux
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Arixtra
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Fondaparinux MOA
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Synthetic pentasaccharide that selectively inhibits Factor Xa viz antithrombin III
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Argatroban MOA
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Direct thrombin inhibitor (Factor IIa) given IV
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Argatroban DOC in:
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HIT
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Bivalirudin
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Angiomax
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Bivalirudin MOA
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Direct thrombin inhibitor (IIa) given IV
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Dabigatran
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Pradaxa
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Dabigatran MOA
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Direct thrombin inhibitor (IIa) given oral
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Dabigatran Indication
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Reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation
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Enoxaparin Prophylaxis of VTE dose
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30mg SC Q12H or 40mg SC daily
CrCl <30mL/min use 30mg SC daily |
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Enoxaparin Treatment of VTE, UA (unstable angina), and NSTEMI
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1mg/kg SC Q12H or 1.5mg/kg SC daily
CrCl <30 1mg/kg SC daily |
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Enoxaparin Treatment of STEMI
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Pt <75yo: 30mg IV bolus + 1mg/kg SC Q12H
Pt >75yo: 0.75mg/kg SC Q12H CrCl<30mL/min 1mg/kg SC daily |
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Rivaroxaban
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Xarelto
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Rivaroxaban MOA
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Factor Xa Inhibitor
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Warfarin
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Coumadin, Jantoven
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Warfarin MOA
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Inhibits C1 subunit of the vitamin K epoxide reductase enzyme complex (VKORC1). thereby reducing the regeneration of Vitamin K epoxide causing depletion of clotting factors II, VII, IX, and X, andproteins C and S
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CHADS2 scoring
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C- CHF
H- HTN A- Age (>75) D- Diabetes S- Prior Stroke/TIA |
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Perioperative Management of Warfarin
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Stop 5 days before major surgery
Can bridge with Lovenox SC or UFH IV DC Lovenos 24 hrs prior to surgery and 4-6 hours prior for UHF Resume warfarin 12-24 hours post surgery and LMWH 24-72 hours post depending on bleeding risk |
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CHADS2 = 0
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No therapy
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CHADS2 = 1 or >
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Dabigatran 150mg BID
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