Anticoagulation

Question 1

warfarin inhibits which factors

Answer 1

II, VII, IX, X

Question 2

heparins inhibit which factors

Answer 2

Xa, thrombin IIa (via antihtrombin)

Question 3

when to use warfarin over DOACs for stroke prevention in AF

Answer 3

mitral stenosis or mechanical heart valve

Question 4

heparin prophylactic dose

Answer 4

5000 units SC q8-12H

Question 5

which weight is used for heparin dosing

Answer 5

total body weight

Question 6

oral anticoagulant uses

Answer 6

afib (stroke prevention), DVT/PE

Question 7

antiplatelet drug uses

Answer 7

CAD, prevent recurrent TIA/ischemic stroke (DAPT)

Question 8

when to use warfarin over DOACs for VTE tx

Answer 8

antiphospholipid syndrome, mechanical heart valve

Question 9

IV anticoagulation option for HIT pt

Answer 9

argatroban

Question 10

heparin antidote

Answer 10

protamine

Question 11

when is bivalirudine preferred for management of HIT

Answer 11

urgent cardiac surgery or PCI

Question 12

savaysa

Answer 12

edoxoban

Question 13

use decreased eliquis dose if

Answer 13

2 of 3: 80yo+, 60kg+, SCr 1.5+

Question 14

apixiban dosing DVT/PE treatment

Answer 14

10 mg BID X 7 d, then 5 mg BID

Question 15

common boxed warning for anticoags

Answer 15

neuraxial anesthesia

Question 16

Factor Xa inhibitor antidotes

Answer 16

andexanent alfa

Question 17

apixiban is a substrate of

Answer 17

CYP3A4

Question 18

edoxoban interactions

Answer 18

rifampin (avoid), macrolides, oral itraconzole and ketoconazole

Question 19

angiomax

Answer 19

bivalirudin

Question 20

dabigatran antidote

Answer 20

idarucizumab (praxbind)

Question 21

anticoag with no renal adjustment

Answer 21

UFH

Question 22

cobicistat containing drugs that can increase dabigitran exposure

Answer 22

stribild, genvoya

Question 23

dabigatran moa

Answer 23

direct thrombin inihibitor

Question 24

warfarin colors

Answer 24

Please let greg brown bring peaches to your wedding (1-10mg)

Question 25

genes that will inc bleeding risk of warfarin

Answer 25

2C9*2/3, VKORC1

Question 26

warfarin side effects

Answer 26

bleeding, purple toe syndrome, skin necrosis

Question 27

goal inr

Answer 27

2-3 (2.5-3.5 if mitral valve or 2 mechanical valves)

Question 28

more potent enantiomer of warfarin which is a racemic mixture

Answer 28

S-warfarin

Question 29

2C9 inducers that dec INR

Answer 29

carbamazepine, phenobarbitol, phenytoin, rifampin

Question 30

2C9 inhibitors that inc INR

Answer 30

amiodarone, azole antifungals, metronidazole, bactrim

Question 31

avoid warfarin with

Answer 31

tamoxifen

Question 32

foods that inc bleeding risk with warfarin

Answer 32

5Gs (ginger, garlic, gingko, ginseng, glucosamine), chamomile, high dose fish oil, vitE

Question 33

how often is INR testing done

Answer 33

4 weeks (12 if stable)

Question 34

max dose protamine

Answer 34

50 mg

Question 35

Kcentra should be administered with

Answer 35

vitamin k

Question 36

preferred route of administration for vitamin K

Answer 36

oral

Question 37

vitamin k is indicated for INR of

Answer 37

>10

Question 38

when to stop warfarn before surgery

Answer 38

5 days before

Question 39

true or false: ASA and anticoags can be used for long distance travelers at risk for VTE

Answer 39

FALSE

Question 40

VTE tx duration

Answer 40

3 months

Question 41

CHADS2VASc

Answer 41

CHF, HTN, age75+, diabetes, stroke, vascular disease, age,65-74, sex (female)

Question 42

preferred anticoag in pregnancy

Answer 42

LMWH

Question 43

rivaroxaban missed dose counseling

Answer 43

can take two doses at same time to make up for missed dose (if bid)

Question 44

Enoxaparin VTE tx dosing

Answer 44

1mg/kg BID (QD if CrCl<30)

Question 45

warfarin contraindication

Answer 45

pregnancy

Question 46

warfarin major distribution consideration

Answer 46

highly protein bound