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Flashcards in Anticoagulation in Pediatric Patients Deck (25)
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1

The anticoagulant most frequently used for DVT/PE in children

LMWH

2

DOACs may be considered in what pediatric subgroup

Adolescent patients weighing >/= 50 kg

3

Recommended labs prior to anticoagulation initiation

Baseline PT, PTT, CBC, and SCr
Pregnancy testing in menstruating females starting on warfarin

4

LMWH anti-Xa target level for treatment

0.5 - 1.0 IU/mL (peak)

5

LMWH anti-Xa target level for prophylaxis

0.1 - 0.3 IU/mL (peak)

6

When to draw LMWH anti-Xa level (dose-wise)

After the 3rd or 4th dose

7

When to start LMWH anti-Xa monitoring

Within two weeks after initiation
To assess for accumulation

8

Is DVT prophylaxis routinely recommended for non-adolescent pediatric hospitalized patients?

No

9

Warfarin starting dose inpatient (no liver dysfunction)

0.2 mg/kg (max 7.5 mg daily dose)

10

Warfarin starting dose inpatient (liver dysfunction)

0.1 mg/kg (max 5 mg daily dose)

11

If patient on warfarin going for procedure and INR is > 1.5 on the day of procedure

Vitamin K 1.25 mg stat day of procedure

12

LMWH interruption guidance for periprocedural management

Hold LWMH 12 - 24 hours prior to procedure
Restart as soon as safe
Renal insufficiency may require longer holds

13

Warfarin interruption guidance for periprocedural management

Hold warfarin 1 - 2 days depending on procedure risks
Renal insufficiency may require longer holds

14

Warfarin to LMWH/UFH bridging guidance for periprocedural management

Only for high thromboembolic risk

Hold warfarin 3 - 5 days prior to procedure

If LMWH:
Start LMWH within 36 hours of the first held warfarin dose
Stop LMWH 12 hours prior to procedure if twice daily LMWH dosing

If UFH:
Stop UFH at least 4 hours prior to procedure

Check INR on day of procedure

15

Enoxaparin treatment dose for premature neonate

2 mg/kg/dose SQ q12 hours

16

Enoxaparin treatment dose for full term neonate

1.7 mg/kg/dose SQ q12 hours

17

Enoxaparin treatment dose for 1 - 3 month infant

1.5 mg/kg/dose SQ q12 hours

18

Enoxaparin prophylaxis dose for < 2 month infant

0.75 mg/kg/dose SQ q12 hours

19

Enoxaparin prophylaxis dose for > 2 month infant

0.5 mg/kg/dose SQ q12 hours

20

If thrombolytic is being used, how often to monitor labs

Every 6 - 12 hours during systemic thrombolysis

21

When does the ASH 2018 guideline recommend Using antithrombin replacement therapy?

When standard anticoagulation has not worked and the patient has low AT levels

22

Does the ASH 2018 guideline recommend using anticoagulation in neonates with renal vein thrombosis (RVT)?

Yes

23

ASH 2018 recommendation for protein C deficiency (congenital purpura fulminas)

Protein C replacement with or without anticoagulation

24

ASH 2018 recommendation for portal vein thrombosis with occlusive thrombus

Use anticoagulation

Anticoagulation is not suggested if nonocclusive thrombus or portal vein hypertension

25

ASH 2018 recommendation for CSVT with hemorrhage

Use anticoagulation