Naplex Review Chapter 31 Anticoag

Front 1

which meds work by binding antithrombin III

Back 1

unfractionated heparin, low molecular weight heparins, and fondaparinux

leading to a decrease in factor Xa

Front 2

which meds specifically inactivate factor Xa

Back 2

LMW> Unfractionated heparin

fondaprinux is selective factor Xa inhibitor-still requires AT binding to work

Front 3

why are IV direct thrombin inhibitor so important

Back 3

they do NOT cross react with heparin-induced thrombocytopenia (HIT) antibodies

Front 4

what is the PO direct thrombin inhibitor DOC

Back 4

Dabigatrin

Front 5

how does rivaroxaban work

whats the brand name

Back 5

inhibits factor Xa

Xarelto

Front 6

how does UFH work

Back 6

binds AT3, inactivating factors IIa (thrombin) and Xa

Front 7

what is the prophylaxis dose of VTE for UFH

Back 7

5,000 units SC Q8-12 H

Front 8

UFH
dosed based on. (weight)
antidote:
SE
how to monitor

Back 8

dosed based on actual body weight

protamine 1mg reverses 100 units of heparin (max 50 mg )
SE-bleeding and HIT
monitor- via aPTT (therapeutic range of 1.5-2.5

Front 9

LMWH MOA

Back 9

like UFH, but more specific Xa inhibition

Front 10

Enoxaparin
brand?
prophylaxis dose of VTE
Tx dose of VTE and NSTEMI

Back 10

VTE prophyl- 30 mg SC Q 12 H/ 40 mg SC daily

Tx of VTE/NSTEMI- 1mg/kg SC Q 12 H (CRCL <30) or 1.5 mg/kg SC Daily

Front 11

enoxaparin
tx dose of STEMI

Back 11

<75 IV bolus of 30mg then 1mg/kg q 12 H

>75 NO BOLUS, just .75mg/kg q 12 H

if <30ml/min do 1mg/kg DAILY

Front 12

IF pt is to undergo PCI (balloon) and received enoxaparin 8 H ago, what should be done

Back 12

give 0.3 mg/kg IV bolus

Front 13

dalteparin
brand

Back 13

fragmin

Front 14

what category is warfarin
UFH?
LMWH?

Back 14

warfarin + UFH = Cat x + C

LMWH= cat B!!

Front 15

fondaparinux
brand
prophylaxis VTE dose
tx of VTE dose
CI

Back 15

arixtra

Prophyx- 2.5 mg SC daily

tx: <50 kg = 5mg daily
50-100 kg = 7.5 mg daily
>100 kg = 10 mg daily

CI- CrCl <30 ml/min

Front 16

direct thrombin inhibitors
meds

Back 16

lepirudin
argatroban
bivalirudin (angiomax)
desirudin
dabigatrin

Front 17

dabigatrin
dosing directions
SE
PREG CAT

Back 17

med must be used within 4 months of opening bottle, keep in original container

SE- gastiritis, bleeding
Cat C

Front 18

per CHEST guidelines which is preferred, warfarin or dabigatrin

Back 18

dabigatrin, prevented more strokes - preferred for A.Fib

Front 19

rivaroxaban
indications

BBW

Back 19

non valvular Afib- take with evening meals
Prophylaxis of DVT and tx of DVT/PE

BBW-spinal punctures, and D/Cing in pts with non valv A. Fib (increased stroke)

Front 20

warfarin
MOA

Back 20

reduces vit K via inhibiting VKORC1 enzyme
depleting factors II, VII, IX, X and protein C + S

Front 21

warfarin
is a racemic mixture of...
which is more potent

Back 21

R and S enanitomers

S- is 3-4 X more potent

Front 22

warfarin colors
pink=
yellow=
tan=
green=
white=
teal=
peach=
blue=
lavender=

Back 22

p1nk= 1
lavender = 2 (e's) =2 mg
green= 2e's and 5 letters total = 2.5 mg
tan= 3 letters= 3 mg
blue= 4 letters = 4mg
peach = 5 letters = 5 mg
teal= think Steal, S = 6mg
yellow= steelers touchdown = 7.5 mg
white= white ppl are 10's, 10 mg

Front 23

meds like aspirin used with warfarin may cause
what to happen to bleeding?
what to happen to INR

Back 23

increase Bleeding, but INR may remain unchanged

Front 24

Vitamin K
what form is preferred
infused slow, why?

Back 24

PO is preferred, but IV is used in a serious bleeding pt

infuse slowly, reports of anaphylaxis

Front 25

when should vitamin K be used

Back 25

when INR >10 and no bleeding, HOLD warfarin and start oral vitamin K 2.5 mg or 5 mg

if bleeding-give IV vitamin K 5-10mg slowly and prothrombin complex concentrate

Front 26

CHADS scoring system
what is it

Back 26

C-CHF
H-HTN
A-Age >75
D-dabetes
S-Stroke/TIA

all = 1 pt, except stroke/TIA = 2 pts

Front 27

Chest guidelines
pt with Afib >48H attempting cardioversion

Back 27

warfarin for 3 wks prior to and 4 weeks after cardioversion

<48 H, start anticoag tx, attempt cardioversion, and tx for 4 weeks after cardioversion

Front 28

CHADS score of 0
what to use

Back 28

aspirin 75mg - 325 mg daily

Front 29

CHADS score of 1

Back 29

use oral anticoag over ASA (favors dabigatrin)

if unable to take anticoag- use ASA + clopidogrel

Front 30

CHADS score of > or = 2

Back 30

oral anticoag- favors dabigatrin over warfarin

Front 31

specific enoxaparin dosing directions
airbubbles

Back 31

do not expel the air bubble unless the dr has told you to do so