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29 Cards in this Set
- Front
- Back
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What coagulation pathway is involved in venous thrombosis?
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intrinsic pathway
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What is virchows triad?
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hypercoagulable state
endothelial injury circulatory stasis |
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What is Heparin's MOA?
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binds to antithrombin III (activating it)
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What is the prophylaxis dose of heparin?
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5,000 units SC BID or TID
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What is the treatment dose of heparin?
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80 units/kg IV bolus
(18 units/kg/hr) |
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What is the target aPTT when on heparin therapy?
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1.5-2.5 X baseline
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During heparin therapy how often should aPTT be checked until therapeutic level is achieved?
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every 6 hrs
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What are the LMWH?
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Enoxaparin
Dalteparin |
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What is the prophylaxis dose of enoxaparin?
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30-40 mg SC daily
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What is the treatment dose of enoxaparin with normal renal function?
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1 mg/kg SC every 12 hrs
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What is the treatment dose of enoxaparin for renal dysfunction (CrCl <30 ml/min)?
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1 mg/kg SC every 24 hrs
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What is the treatment dose of enoxaparin for obese patients?
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1 mg/kg SC every 12 hrs
(max of 150 mg SC every 12 hrs) |
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How is LMWH easier to use than heparin?
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-can be given SC for treatment rather than IV
-longer duration of action -less thrombocytopenia -more predictable therapeutic effect -does not require blood test monitoring |
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What is the factor Xa inhibitor drug?
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Fondaparinux
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What drug is used in patients with a hx of heparin induced thrombocytopenia?
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fondaparinux
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How does warfarin work?
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inhibits Vit K clotting factors (2,7,9,10)
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Warfarin interacts significantly with what other drugs?
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antibiotics
antiplatelets NSAIDs |
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A large loading dose of what medication may cause hemorrhagic complications?
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warfarin
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What is the starting dose of warfarin?
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5 mg daily
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What is the therapeutic INR for VTE?
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2-3 (normally 1)
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How long should warfarin therapy be continued?
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first episode: 3-6 months
second or more episode: lifelong therapy |
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What is the goal INR in a patient with a mechanical heart valve?
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2.5-3.5
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When is Vit K administered for over-anticoagulation?
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INR >9
unless active bleeding (give 2.5 mg PO or 1 mg IV) |
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When can bridging therapy be d/c?
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when therapeutic INR is achieved for 2-3 consecutive days (or at least 5 days)
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What patients need bridging?
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High risk: recent VTE (within 3 months), severe thrombophilia
Moderate risk: VTE withing 3-12 months, non severe thrombophilic conditions, recurrent VTE, active cancer |
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What patient does NOT need bridging?
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low risk: single VTE occurred > 12 months ago and no other risk factors
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When do you stop warfarin therapy before a procedure?
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5 days before procedure
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When do you stop IV UFH or IV LMWH before a procedure?
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UFH: 6 hrs before
LMWH: 24 hrs before |
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When do you resume warfarin therapy after a procedure?
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High/mod risk: 12-24 hrs after
Low risk: 12-48 hrs after (resume at usual dose) |
