Flashcards in CACP Domain 2 Indications and Recommendations Deck (55)
Which anticoagulant is used to treat peripheral arterial embolism?
Which DOAC is used to treat acutely ill medical patients?
Which anticoagulant is used in ECMO, blood transfusions, and dialysis procedures?
Which anticoagulant is used to treat DIC?
Which anticoagulants are used for prophylaxis of DVT in abdominal surgery?
Enoxaparin and Fondaparinux
Can enoxaparin be used for the outpatient treatment of acute DVT with PE?
No, only for outpatient treatment without PE
Which anticoagulant is used for DVT prophylaxis in hip fracture surgery?
(Rivaroxaban, Apixaban, Dabigatran, Enoxaparin, and Fondaparinux are used as DVT prophylaxis for hip replacement surgery.)
When can fondaparinux be used to treat DVT or PE?
When it is given in conjunction with warfarin
When can prasugrel be used to treat STEMI?
When used with PCI
When can tirofiban be used?
Only in non-ST elevated ACS (UA and NSTEMI)
Thrombolytics are approved for the treatment of
Acute myocardial infarction, acute ischemic stroke, acute massive PE (alteplase only)
AHA/ACC/HRS 2019 recommendation for AF, CHA2DS2-VASC score of 2 in men, 3 in women, with CrCl < 15 mL/min or on dialysis
Warfarin or Apixaban (2b recommendation)
Duration of anticoagulation for cardioversion for patients with AF/atrial flutter not < 48 hours (AHA/ACC/HRS 2019)
3 weeks before and 4 weeks after cardioversion at least
(If having to start immediately due to hemodynamic instability, then continue for at least 4 weeks)
ACS - underwent PCI with stent - AF with CHA2DS2-VASc 2+ - now on triple therapy - which P2Y12 inhibitor?
Clopidogrel preferred to prasugrel
ACS - underwent PCI with stent - AF with CHA2DS2-VASc 2+: triple or double therapy?
Double therapy (clopidogrel or ticagrelor + warfarin) preferred
ACS - underwent PCI with stent - AF with CHA2DS2-VASc 2+: what double therapy with DOACs is reasonable?
Rivaroxaban 15 mg daily OR
Dabigatran 150 mg BID
(can consider dabigatran 110 mg BID if bleeding risk is high)
ACS - PCI with stent - AF with CHA2DS2-VASc 2+ on triple therapy, when can transition to double therapy be considered?
At 4 - 6 weeks
INR goal of 3.0 for warfarin patients with what indications
mechanical MVR, older generation mechanical AVR, mechanical AVR with risk factors (AF, previous VTE, LV dysfunction, or hypercoagulable conditions)
When to use ASA and what dose for valvular heart disease
ASA 81 mg daily in conjunction with warfarin for mechanical valve (recommended) or bioprosthetic valve (reasonable)
When does Chest 2017 for valvular heart disease recommend INR goal 1.5 - 2.0?
Mechanical On-X AVR and no VTE risk factors
Chest 2017 TAVR recommendation
Clopidogrel 75 mg daily + ASA 81 mg daily first 6 months, then ASA 81 mg daily lifelong
Anticoagulation with warfarin is reasonable for 3 months and low risk of bleeding
Anticoagulant of choice if patient also takes PGP inhibitors or inducers
Warfarin or Enoxaparin
Anticoagulant of choice if patient also takes strong CYP inhibitors or inducers
Warfarin or Enoxaparin
When does ASH 2018 suggest against using anti-Xa monitoring for LMWH?
CrCl < 30 mL/min or obesity
Duration of anticoagulation therapy for first unprovoked VTE with low or moderate bleeding risk
Duration of anticoagulation therapy for first unprovoked VTE with high bleeding risk
CHEST 2016 recommendation if stopping anticoagulant therapy for unprovoked proximal VTE
ASA 81 mg daily for long term VTE prophylaxis
Should compression stockings be routinely used in acute DVT to prevent post-thrombotic syndrome?
Chest 2016 recommendation for subsegmental PE (no DVT) and low risk of VTE recurrence