Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX STUDY > Anticoagulation > Flashcards

Anticoagulation Flashcards

(69 cards)

Start Studying
1
Q

UFH

A

binds to antithrombin and block factor Xa and IIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LMWH

A

binds to antithrombin and blocks factor Xa and IIa with more Xa blocking than IIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Direct thrombin inhibitors: IV (argatroban and bivalirudin) PO (dabigatran)

A

directly blocks thrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Direct factor Xa inhibitors (rivaroxaban, apixiban, edoxaban)

A

directly blocks factor xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indirect factor Xa inhibitor: fondaparinux

A

binds to antithrombin to block factor xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

warfarin

A

inhibits factors II, VII, IX, and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DOACs vs Warfarin

A

-DOACs have less drug interactions, less bleeding, and shorter DOA than warfarin
- DOACs are adjusted based on kidney/liver function and not INR
-DOACs are preferred for stroke prevention in AF - unless there is mitral stenosis or MVR
-DOACs are preferred for VTE tx unless patient has antiphospholipid syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vitamin K

A

vitamin K is required for the activation of clotting factors II, VII, IX, and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

antithrombin (AT)

A

inactivates thrombin (factor IIa) and other proteases (like factor Xa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hematuria

A

blood in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hematemesis

A

blood in vomit caused by bleeding from the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

UFH: ppx VTE

A

5000 IU SQ Q8-12H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

UFH: tx of VTE

A

80 IU/kg IV bolus; 18 IU/kg/hr infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

UFH: tx of ACS/STEMI

A

60 IU/kg IV bolus; infuse 12 IU/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

UFH dosing

A

use TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

UFH: aPTT/anti-Xa monitoring

A

check 6 hours after initiation and every 6 hours until therapeutic, then every 24 hours and with every dose change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

UFH: aPTT/anti Xa therapeutic range

A

-aPTT: 1.5-2.5 x control
-anti Xa: 0.3-0.7 IU/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HIT

A

PLT decrease > 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

heparin antidote

A

protamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

heparin lock flushes

A

used to keep IV lines open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

LMWH: ppx VTE

A

30 mg SC Q12H or 40 mg SC daily
-CrCl < 30 mL/min: 30 mg SC daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

LMWH: tx of VTE and UA/NSTEMI

A

1 mg/kg SC Q12H or 1.5 mg/kg SC daily (only for inpatient VTE tx)
-CrCl < 30 mL/min: 1 mg/kg SC daily
-use TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

LMWH: tx of STEMI in patients < 75 YOA

A

-30 mg IV bolus + 1 mg/kg SC dose followed by 1 mg/kg SC Q12H
-CrCl <30 mL/min: 30 mg IV bolus plus a 1 mg/kg SC dose then followed by 1 mg/kg SC daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

LMWH: tx of STEMI in patients < 75 YOA

A

0.75 mg/kg SC Q12H with no bolus - max of 5 mg for the first two SC doses only
-CrCl < 30 mL/min: 1 mg/kg SC daily with no bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
LMWH safety
-neuraxial anesthesia (epidural, spinal) are at risk of hematoma and subsequent paralysis -do not use in HIT -Anti-Xa level recommended in pregnancy -monitoring may be done in obesity, LBW, and renal insufficiency -do not expel air bubble from syringe
26
when to obtain peak in enoxaprin monitoring
peak anti-Xa levels 4 hours post SC dose
27
LMWH antidote
protamine
28
management of HIT
1. stop all forms of heparin and LMWH - if on warfarin d/c warfarin and administer vitamin K 2. use rapid acting non-heparin anticoagulants (argatroban) 3. do not start warfarin therapy until the platelets have recovered to > 150K 4. if urgent cardiac surgery or PCI is required - use bivalirudin
29
Apixaban: nonvavular AF
5 mg PO BID -unless > 80 YOA, BW < 60 kg, or SCr > 1.5 mg/dL, then give 2.5 mg BID
30
Apixaban: tx of DVT/PE
initial: 10 mg PO BID x7 days then 5 mg PO BID - can give 2.5 mg PO BID after least 3 months of initial tx dosing
31
Apixaban: ppx DVT
2.5 mg PO BID x12 days after knee or x35 days after hip; give first dose 12-24 hrs after surgery
32
rivaroxaban (xarelto)
doses > 15 mg must be taken with food
33
rivaroxaban: nonvalvular AF
CrCl > 50: 20 mg QD with evening meal 15-50: 15 mg QD with evening meal
34
Rivaroxaban: tx of DVT/PE
-initial: 15 mg PO BID x21 days, then 20 mg PO QD with food -avoid use in CrCl < 30
35
edoxaban
do not use in those with non-valvular AF and CrCl > 95 mL/min -reduced efficacy
36
antidote for apixiban and rivaroxaban
andexanet alfa
37
fondaparinux
contraindicated in those with CrCl <30 mL/min
38
converting from warfarin to another oral anticoagulant, stop warfarin and convert to:
-Rivaroxaban when INR < 3 -Edoxaban when INR < 2.5 -Apixaban when INR < 2 -Dabigatran when INR < 2
39
From DOACs to warfarin
stop DOAC and start parenteral anticoagulant and warfarin at the next scheduled dose
40
from dabigatran to warfarin
start warfarin 1-3 days before stopping dabigatran
41
dabigatran and parenteral anticoagulant
always bridge with parenteral anticoagulants for 5-10 days if used for treatment (not needed for ppx)
42
antidote for argatroban and bivalirudin
no antidote
43
warfarin and pregnancy
contraindicated unless they have mechanical valve
44
CYP2C9*2 or *3 alleles and/or polymorphisms of VKORC1 in warfarin
increase risk of bleeding
45
goal INRs
-most 2-3 -2.5-3.5 for mechanical heart valve
46
S-warfarin
3-5 times more potent than R-warfarin
47
carbamazepine, phenobarbital, phenytoin, rifampin, st. johns
decrease INR
48
amiodarone, azole antifungals, flagyl, and bactrim
increase INR
49
warfarin and amiodarone
when starting amiodarone decrease the dose of warfarin by 30-50%
50
warfarin and tamoxifen
avoid use
51
Please Let Greg Brown Bring Peaches To Your Wedding
Pink - 1 mg Lavender - 2 mg Green - 2.5 mg Brown/Tan - 3 mg Blue - 4 mg Peach - 5 mg Teal - 6 mg Yellow - 7.5 mg White - 10 mg
52
foods high in vitamin k
spinach, broccoli, brussel sprouts, cabbage, beef liver, kale
53
increases bleeding risk with warfarin
garlic, ginkgo, ginseng, glucosamine, vitamin E, high dose fish oils, willow bark, and wintergreen
54
decrease effectiveness of warfarin
st. johns wart
55
protamine for UFH reversal
1 mg will reverse 100 units of heparin -reverse amount given in the last 2-2.5 hours; max dose 50 mg
56
protamine for LMWH reversal
1 mg per 1 mg of enoxaprin
57
dabigatran reversal
idarucizumab (praxbind)
58
K centra
factors II, VII, IX, X, Protein C, Protein S -administer with vitamin K
59
INR above therapeutic range but < 4.5 w/out bleeding
reduce or skip warfarin dose, monitor INR
60
supratherapeutic INR of 4.5-10 without bleeding
-routine vitamin K is not recommend -hold 1-2 doses of warfarin -resume warfarin at lower dose when INR is therapeutic
61
INR > 10 without bleeding
-hold warfarin -oral vitamin K 2.5-5 mg -resume dose when INR is therapeutic
62
major bleeding
-hold warfarin -give vitamin K 5-10 mg by slow IV injection and four-factor prothrombin complex concentrate (PCC)
63
peri-operative anticoagulant management
stop warfarin approx 5 day before major surgery -those mechanical valve, AF or VTE at high risk for thromboembolism, bridge with LMWH or UFH -d/c therapeutic LMWH 24 hrs before surgery
64
VTE: those without cancer
dabigatran and other DOACs are preferred over warfarin for the first 3 months
65
VTE: those with cancer
DOACs are preferred
66
AF > 48 hr
anticoagulate for at least 3 weeks prior to and 4 weeks after cardioconversion
67
AF < 48 hr
start full therapeutic anticoagulation, preform cardioversion, and continue full anticoagulation for at least 4 weeks
68
CHA2DS2-VASc
estimate risk of stroke in AF
69
HAS-BLED
bleeding risk

NAPLEX STUDY (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions