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57 Cards in this Set
- Front
- Back
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Heparin Sodium dose prophylaxis |
5000 units SC q8-12 hrs [indirect thrombin inhibitors] |
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Heparin Sodium dose |
80 units/kg IV push followed by continuous infusion of 18 units/kg/hr s [indirect thrombin inhibitors] |
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Enoxaparin therapeutic dose? |
1mg/kg SC q12hrs s [indirect thrombin inhibitors] |
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Warfarin dose |
5mg 1 tablet daily [vitamin K antagonists] |
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Clopidogrel [Plavax] dose |
75 mg one tablet daily [oral antiplatelet] |
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Rivaroxaban {xarelto} dose
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20 mg one tablet daily [factor Xa]
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Pradaxa dose |
150mg one capsule twice a day (direct thrombin inhibitors) |
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alteplase dose |
0.9 mg/kg (90 mg MAX) administer 10% of total dose as a bolus dose and infuse the remainder over 1 hr [thrombolytics] |
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aranesp
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0.75 mcg/kg sq once every 2wks (erythropoietin)
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folic acid
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1 mg one tablet daily (macrocytic anemia)
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cyanocobalamin (b12)
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100 mcg IM once every 30 days (macrocytic anemia)
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iron sucrose injection
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100 mg IV during dialysis for 10 doses (microcytic anemia)
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ferrous sulfate
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325mg one tablet 3 times a day with or after meals (microcytic anemia)
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droxia |
500 mg take 5 capsules once a day [anti sickle] |
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What reverses heparin & when to use it? |
protamine sulfate when heparin is still in body (so closer to initial dose) |
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What is the risk factor for HIT and what should you worry about? |
prior exposure to heparin, creation of look for thrombocytopenia (50% drop in platelets)
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what is warfarin used for?
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prophylactic & treatment of thromboembolic disorders and embolic complications reduce risk of systemic embolism post MI |
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How many INR readings do you need and at what level to stop heparin bridge?
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2 readings in a row at level 2 or above.
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How did warfarin get it’s name?
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Wisconsin Alumni Research Foundation first research on cows but used in 1950’s rat poison-->bleed out |
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what things increase warfarin effect?
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amiodarone, ginkgo, statins, omeprazole
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what things decrease warfarin’s effect?
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estrogens, protease inhibitors, st johns wort
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How to reverse purple toe and when do you give it?
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reverse with phytonadione (vitamin K) oral & IV
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Rivaroxaban {xarelto} is used for... |
DVT tx and prevent, nonvalvular afib, PE tx and prevent
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What to watch out for in factor Xa inhibitors
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adjust for renal dosing, CYP3A4 & P-glycoprotein drug intrxn (apixaban his a lot more intrxn)
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ADR of factor Xa
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peripheral edema, dizzy, headache, bleeding risks
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WHat is Dabigatran [pradaxa] used for?
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prevent stroke & systemic embolism with nonvalvular afib
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ADR of oral direct thrombin inhibitor [pradaxa] |
Bleeding, GI issues-dyspepsia, renal issues <30 ml/min |
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Why would you use argatroban? |
HITT patient (50% drop platelets) and can’t use heparin
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Official use of bivalirudin [angiomax]
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stop clotting during PCI in cath lab
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Virchow’s Triad
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stasis, injury, hypercoagulability
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S&S DVT |
mild palpation discomfort in lower calf, swelling & tenderness
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S&S PE
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dyspnea, tachypnea, syncope, cyanosis, pleuritic pain, cough, hemoptysis
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risk factors for DVT
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prior DVT, 60+yrs, knee or hip surgery, major trauma, malignant disease, hypercoagulable condition, prolonged immobilization
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Preventing DVT
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ambulation, compression stockings, pneumatic compression, anticoagulants *heparin
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PE risk factors
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stroke paralysis, malignant, CH, autoimmune disease, immobilization, surgery in last 3 months, women[obese, smoker, htn] |
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how do indirect thrombin inhibitors work?
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drug molecules wraps around and activates antithrombin III
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what is heparin sodium used for?
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prophylaxis & treatment of thromboembolic disorders, post MI
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WHat is enoxaparin used for?
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DVT prophylaxis & treatment
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What is fondapariux used for?
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DVT prophylaxis & acute DVT without PE treatment and acute PE
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Prophylaxis dose of heparin sodium
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5000 units SC q 8-12 hrs (no lab tests for this) |
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ADR of indirect thrombin inhibitors
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Bleeding, HIT [drop in platelets w/in 5-10 days]
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reversal of heparin
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protamin sulfate
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Heparin treatment dosing
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80 units/kg IV push followed by continuous infusion 18 units/kg/hour
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what factors need Vitamin K?
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2, 7, 9, 10
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How long until you see warfarin drug effect? What to do in meantime?
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warfarin [oral] takes 3-5 days to work you should give a heparin bridge [IV] at same time |
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Ideal INR reading for warfarin?
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2-3 most disorders [valve disorders 2 1/2-3 1/2]
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ADR of vitamin K antagonists[warfarin]?
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drug to drug intrxn, bleeding *do not drink!
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How do oral antiplatelets work?
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they interact at the receptor to down regulate it and don’t pull in fibrinogen
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What does clopidogrel used for?
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acute MI, recent infarction or stroke, peripheral vascular disease
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What does clopidogrel need in order to be activated?
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2C19
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WHat do you need to do to recognize signs of stroke? |
Face Arm Speech Time |
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What is the most common kind of stroke?
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ischemic but hemorrhagic is high mortality |
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ADR of oral antiplatelets
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thrombotic thrombocytopenic purpura (ttp), rash, pruritus, bleeding
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anemia causes some risk factors for increased mortality
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chronic kidney disease, malignancy, HF, MI
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causes of iron deficiency
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diet, blood loss, increased utilization[pregnancy, adolescent growth], lead poisoning |
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What lab value goes up with iron deficiency?
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TIBC
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what can you add to increase iron absorption?How much elemental do you need to reverse iron deficiency anemia?
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vitamin C, 200-400 mg needed per day |
