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Anticoag dosing Flashcards

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1
Q

What weight is used for UFH dosing?

A

Actual body weight

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2
Q

Dosing UFH for VTE prophylaxis?

A

SC 5,000 Units SCQ8-12

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3
Q

Dosing for treatment of VTE for UFH?

A

80 units per kg IV followed by 18 units/kg/hr

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4
Q

Dosing for treatment of ACS or STEMI UFH

A

60 units/kg IV bolus max 4,000 Units

then 12 units/kg/hour infusion

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5
Q

Tetsing therapeutic levels for UFH? when and what

A

aPTT or anti Xa

aPPT taken 6 hours after initiation

Take every 6 hours until therapeutic range of 1.5-2.5 x patients baseline

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6
Q

What is the CrCl cut off for lovenox for VTE prophylaxis and hat is the dose?

A

CrCl<30

30 mg SC daily

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7
Q

VTE prophylaxis dosing for lovenox?

A

30 mg SC q12h or 40 mg SC daily

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8
Q

Treatment of VTE and UA/NSTEMI for lovenox?

A
  1. 1 mg/kg q12h
  2. or 1.5 mg/kg SC daily only for inpatient VTE treatment
  3. CrCl<30 mL/min 1mg/kg SC daily
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9
Q

What wt is used for lovenox and UFH?

A

Actual body wt

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10
Q

Tx of STEMI with Lovenox? <75

A

30 mg IV bolus plus a 1 mg/kg dose

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11
Q

Stemi Lovenox treatmnet <75 and CrCl <30

A

Same as normal pt less then 75

30 mg IV bolus plus a 1 mg/kg SC dose

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12
Q

Lovenox STEMI tx pt >75

A

0.75 mg/kg Q12 no bolus

CrCl< 30 1 mg/kg SC daily no bolus

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13
Q

If a patient has a CrCl< 30 what is the change in dosing usually for lovenox?

A

Change from q12 to daily

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14
Q

Drugs that increase blood pressure 7

A, C, D, E, I, N, S

A
  1. Amphetamines
  2. Cocaine
  3. Decongestants
  4. ESA
  5. Immunosuppressants
  6. NSAIDs
  7. Systemmic steroids
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15
Q

COmbo ACE or ARB + Diuretics 4

A
  1. Zestoretic
  2. Hyzaar
  3. Divan
  4. Benicar
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16
Q

ACE or ARB + CCB 2

A

Lotrel: Benazipril+amlodipine

Exforge: Valsartan/Amlodipine

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17
Q

Direct renin inhibitor + Diuretic 1

A

Aliskeren/HCTZ Tekturna HCT

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18
Q

Alpha 2 agonist + Diuretic 1

A

Methyldopa/HCTZ

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19
Q

BB + Diuretic? 2

A

Tenoretic; Atenolol+Chlorthalidone Tenoretic

Bisoprolol/HCTZ: Ziac

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20
Q

K sparing + thiazide type 1

A

Triamteren/HCTZ Maxide Dyazide

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21
Q

WHen should pregnant patient be treated with HTN meds?

A

SBP>= 160

DBP>=105

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22
Q

What are the 3 preferred meds for Pregnant HTN?

A

Labetalol, nifedipine ER, methyldopa

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23
Q

Microzide

A

HCTZ

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24
Q

When are thiazides not effective?

A

CrCl<30

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25
Only thiazide available in IV?
Chlorthalidone
26
7 SEs of Thiazides
1. Hypo Everything, except for calcium and uric acid 2. Hypokal 3. Hypomag 4. Hyponat 5. Hypercal 6. Increase LDL and TG 7. Hyperglycemia
27
THiazides decrease the clearance of what drug?
Lithium increased toxicity
28
Most common SEs of non-DHPs
1. Fluching 2. Reflex tachycardia 3. HA 4. Peripheral edema
29
What CCB is the DOC in pregnancy?
ER nifedipine (Adalat and Procardia)
30
All CCBs both DHPs and Non- can cause what?
Gingival hyperplasia but more so with verapamil
31
Lotensin
Benazopril
32
Vasotex and Vasotec IV
Enalaprilat
33
Altace
Ramipril
34
MOA of ACE
Block conversion of Ang 1-Ang2
35
Boxed warning for ACEs
Fetal toxicity
36
Contraindications to ACEs
Hx of Angioedema use within 36 hours of neprilysn inhibitor (Sacubirtil/Valsartan)
37
5 warnings of ACes
1. Angioedema 2. hyperkalemia 3. hypotension 4. renal impairment 5. Bilateral renal arterialstenosis
38
ARB MOA?
Block binding of Ang II to anf II type receptor ATI
39
What combo is contraindicated in DM patietns?
Aliskeren in combo with ACE or ARB
40
Avapro?
Irbesartan
41
Cozaar
Losartan
42
Olmesartan warning?
Sprue-like enteropathy
43
All forms of carvedolol?
Should be taken with food
44
Beta 1 selective BBs? 3
Atenolol Esmolol Metoprolols
45
Tenormin
Atenolol
46
Brevibloc
Esmolol
47
Lopressor and Toprol?
Should be taken with or immidiately after meal
48
Metoprolol Tartrate IV to PO
1:2.5
49
Beta 1 selective AMEBBA
Atenolol, Metoprollol, Esemolol, Bisprolol, ACE butolol
50
Catapress
Clonidine
51
What is the DOC in pregnancy?
Methyldopa
52
Catapress patch instructions?
Apply weekly
53
Methyldopa can cause what?
DILE
54
What BBs are teratogenic?
ACE, ARB, Aleskerin
55
What does hydralazine do?
Causes vasodilation of the arteries
56
Hydralazine formulations?
IV and PO
57
Warning for Hydralazine?
DILE
58
What two HTN meds can cause DILE?
MEthyldopa Hydralazine
59
All women of child bearing age should get what?
Folate 400 mcg/day
60
What supplementation should prgnant women get?
Increase folate to 600 mcg/day
61
Pregnant women age 19-50 should get what?
Calcium 1000 mg/day and 600 IU/day VitD
62
Acne drugs that are teratogenic?
Isotretinoin, topical retinoids including tazoteren
63
ABx that are teratogenic 2
Quinolone and Tertracyclines
64
Anticoags that are teratogenic?
Warfarin but special considerations
65
Dyslipidemia, HTN, and HF drugs that are teratogenic? 2
Statins any RAAS drugs
66
Hormones that are teratogenic?
Pretty much all of them
67
Migraine meds that are teratogenic? 2
Dihydroergotamine Ergotamine
68
Other teratogenic drugs 10 H,L,M,M,P,R,T,T,W,D
1. Hydroxyurea 2. Lithium 3. Methotrexate 4. Misoprostol 5. Paroxetine 6. Ribavirin 7. Thalidomide 8. Topiramate 9. Wt loss drugs / valrpoic acid 10. Divalproex
69
HTN in preg 3 pref
Labetolol Methyldopa Nefidipine
70
Vaginal fungal infection in preg?
Topical antifungals x 7 days
71
Main drugs for UTI in preg 2
Cephalexin Ampicillin x 7 days
72
What two drugs are last line in UTI in preg?
Nitro Bactrim
73
VTE in preg
LMWH is preferred over UFH
74
Note about UTI in preg?
Must treat bacteruria even if asymptomatic with negative UI
75
Hypothyroidsim DOC for preg?
Levo increse dose by 30-50%
76
Anticoag drugs that are not recommeneded in pregnancy
Warfarin is teratogenic oral factor Xas are not recommened
77
If patient has hyperthyroidism and needs treatment like graves disease
Propylthiouracil is preferred if trying to concieve and in the 1st trimester Can swithc to methamazole during preg
78
Pain meds that should not be used in pregnancy?
Codein and Tramadol
79
Babies that are breastfeeding or partial should get what?
400 IU of VIt D per day
80
Breasfed babies require what else?
1mg/kg dailt of iron for 4-6 months
81
Drugs that should not be used during breastfeeding? 6
1. Amphetamines 2. Ergotamines 3. Lamotrigine 4. Lithium 5. Statins 6. Metro should be avoided or pump and dump
82
What can be used for motion sickness in preg?
Trial lifestyle changes if not Vit B6 Pyridoxine +/-doxylamine firdt line
83
Preg Cat A
Controlled studies in animals and women show no risk
84
Preg Cat B
Animal studies show no risk but there are no controlled studies in women
85
Preg Cat C
Animal Studies show harm to the fetus and there are no controlled studies available or studies are not available give if benefit outweighs risk
86
Preg Cat D
Positive evidence of fetal harm but beneift mght outweigh risk
87
Pre cat X
DO not use in pregnancy
88
Drugs to avoid in pediatrics Contraindicated 4
1. Codeine \< 12 2. Tramadol \< 12 3. Promethazine \<2 4. Ceftriaxone in neonates 1-28 days
89
Drugs to avoid in pediatrics not generally recd
1. Quinolones 2. Tetracycline \<8 3. OTC teething meds with benzocaine \<2 4. OTC cough and cold \< 6
90
Acetaminophen child dosing?
10-15 mg.kg q4-6, max 75 mg/kg/day
91
Max ibuprofen dose in children?
5-10 mg/kg q6-8 max 40 mg/kg/day

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