Exam 3 - Thrombosis Flashcards
(31 cards)
VTE treatment - UFH regular IV dosing
80 U/kg IV bolus followed by 18 U/kg/hr iV infusion
VTE treatment - UFH regular subQ dosing
initial dose of 333 U/kg subQ, followed by 250 U/kg subQ q12hrs
UFH renal adjustments
None
Is monitoring required for both IV and subQ UFH treatment?
No, only required for IV treatment
monitoring parameters for UFH IV treatment
aPTT 6 hrs after bolus and each dose adjustment OR anti-Xa activity for pts with excess factor VII or large doses
target range for aPTT
1.5-2.5x the normal value
VTE treatment - enoxaparin regular dosing
1 mg/kg subQ q12hrs OR 1.5 mg/kg subQ q24hrs
VTE treatment -
enoxaparin renal adjustments
For CrCl < 30 mL/min, 1 mg/kg q24hrs subQ
monitoring parameters for enoxaparin
anti-Xa activity for pregnant pts, burn pts, severe renal impairment, pts with extreme weights (< 50 kg/> 190 kg), prolonged therapy
VTE treatment - dalteparin regular dosing
100 U/kg subQ q12hrs OR 200 U/kg subQ q24hrs
dalteparin renal adjustments
None
What is the regular dosing for fondaparinux in VTE treatment?
< 50 kg = 5 mg subQ q24hrs
50-100 kg = 7.5 mg subQ q24hrs
> 100 kg = 10 mg subQ q24hrs
What renal adjustments are required with fondaparinux treatment?
CI for CrCl < 30 mL/min
What monitoring parameter are required for fondaparinux treatment?
anti-Xa activity
What is the regular dosing for apixaban in VTE treatment?
10 mg PO q12hrs for 7 days, followed by 5 mg PO q12hrs
What are the renal adjustments required with apixaban treatment?
CI for CrCl < 25 mL/min
What is the regular dosing for rivaroxaban in VTE treatment?
15 mg PO q12hrs for 21 days, followed by 20 mg PO q24hrs
What are the renal adjustments required with rivaroxaban treatment?
CI for CrCl < 30 mL/min
What is the regular dosing for edoxaban in VTE treatment?
60 mg PO daily OR 30 mg PO daily for pts less than or equal to 60 kg
What are the renal adjustments required with edoxaban treatment?
CI for CrCl < 15 mL/min
What is the regular dosing for dabigatran in VTE treatment?
150 mg PO q12hrs
What are the renal adjustments required with dabigatran treatment?
CI for CrCl < 30 mL/min
What are the oral therapies that cannot be started right away and the parameters needed prior to administration?
edoxaban and dabigatran cannot administered until 5-10 days of parental anticoagulation therapy is received
What is the brand name of enoxaparin?
Lovenox
