Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Therapeutic Dosing > Final part 3 > Flashcards

Final part 3 Flashcards

(50 cards)

Start Studying
1
Q

Heparin MOA

A

binds with antithrombin to inactivate factors 10 & 2

- also 9, 11 & 12

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

no renal dose adjustments for

A

heparin & warfarin

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

prior to initiation of heparin therapetic doses must know:

A

indication
total body weight
baseline aPTT/anti-Xa & plts
- double check hgb

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

heparin for VTE

A

80u/kg then 18u/kg/hr

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

heparin for ACS

A

60u/kg then 12 u/kg/hr

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

heparin for VTE prophylaxis

A

500u SQ Q8-12H

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

heparin aPTT monitoring

A

may stop Q6H monitoring after 2 aPTTs in range & go to daily checks
- plts Q3 days

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

prophylactic monitoring for heparin

A

none

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

lovenox generic

A

enoxaparin

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

lovenox MOA

A

binds antithrombin to inactivate factors (X>II)

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

dosing considerations of enoxaparin

A

indication
renal function
total body weight

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

therapeutic dosing for enoxaparin

A
  • 1mg/kg Q12H if CrCl>30

- QD if CrCl

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

VTE prophylaxis enoxaparin dose

A
  • medical/surgical:40mg SQ QD
  • knee replacement: 30 SQ BID
  • CrCl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

enoxaparin monitoring

A
  • anti-Xa
  • indicated with treatment doses in:
    prego, wt 190kg
  • CrCl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

enoxaparin anti-Xa level targets

A
  • Q12H CrCl>30 or QD CrCl 30:1-2

- prophylaxic: 0.2-0.6

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

fragmin generic

A

dalteparin

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

dalteparin MOA

A

binds with antithrombin to inactivate factors X>II

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

dalteparin prophylaxis dosing

A

500u SQ daily

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

what is the agent of choice for reversal of heparinoids?

A

protamine sulfate

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

arixtra generic

A

fondaparinux

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

fondaparinux indications

Study These Flashcards
A
  • VTE prophylaxis: 2.5mg SQ QD
  • VTE treatment: (100:10mg)
  • CI in CrCL
22
Q

MOA of argatroban

Study These Flashcards
A

direct thrombin inhibitor

23
Q

argatroban indications

Study These Flashcards
A
  • prevention/treatment of HIT

- PCI

24
Q

argatroban monitoring

Study These Flashcards
A
  • aPTT

- prolongs INR

25
consider addition of warfarin to argatroban infusion when:
confirmed HIT PLUS plts >150
26
overlap warfarin & argatroban for
at least 5 days before dc argatroban
27
angiomax generic
bivalirudin
28
bivalirudin MOA
direct thrombin inhibitor
29
bivalirudin dosing
- PCI: 0.75mg/kg x1 then 1.75mg/kg/hr | - HIT:0.15-0.2mg/kg/hr
30
bivalirudin monitoring
- HIT: aPTT levels | - PCI: once time ACT
31
peri-operative for heparin
hold 4-6 hours before surgery & weight 48-72 hours after for high risk bleeders (24 for non-high risk)
32
peri-operative for LMWH
- 24 hours before & 24 hours after
33
warfarin MOA
- inhibits vitamin K epoxide reductase (VKOR) complex to reduce vitamin K available for the synthesis of SNOT, & Protein C & S
34
warfarin initial dose
5mg PO QD (5-10) | - may use 10mg x 2 day loading dose if healthy
35
sensitivity factors for warfarin
- use 2.5mg QD - age over 75 - liver or renal disease - HF - high bleeding risk - drug interaction - acute etOH intake - smoking cessation - poor nutritional status - infection - malignancy
36
cyp2c9 & Vkorc1 genotyping
- currently not recomended
37
agents that increase warfarin efficacy & bleeding
``` amiodarone fluconazole metronidazole NSAIDs sulfonamides "G" herbals other anticoags ```
38
agents that decrease warfarin efficacy
rifampin st johns wort carbamazepine
39
INR measures factors
II, VII, & X
40
warfarin titration
INR: - less than1.5: incr wk 10-20% - 1.5-1.9:incr wk 5-15% - 2-3 continue - 3.1-3.5: decr wk 5-15 - 3.6-4.4: dec 10-20% & hold 2 doses - more than 4.5: follow flow chart
41
warfarin INR follow up times
- initiation (outpt): 5-7 days - out of range (less than 4.5) or 1 INR in range: 1-2 wks - 2 or more in range: 4 wks - severe bleeding: PRN - INR more than 10: 1-2 days - INR 4.5-10: 2-3 days
42
warfarin bridging therapy is most appropriate in:
VTE, Afib & valve replacement - initiate warfarin & IV anticoag on day 1 - for at least 5 days until 2 INRs are above 2 24 hours apart
43
pradaxa generic
dabigatran | - direct thrombin inhibitor
44
pradaxa dosing
- 150mg PO BID - must complete 5-10 days IV - DVT or nonvalv AF
45
xarelto generic
rivaroxaban | - factor Xa inhibitor
46
xarelto dosing
- acute DVT: 15mg PO BID x21 then 20mg QD - nonvalv: 20mg QD - prophylaxis: 10mg QD
47
eliquis generic
apixaban | - factor Xa inhibitor
48
eliquis dosing
- DVT: 10mg PO ID x7 days then 5mg BID - nonvalv: 5mg BID - prophylaxis: 2.5mg BID
49
savaysa generic
endoxaban | - factor Xa inhibitor
50
savaysa dosing
- dvt: 60mg QD - must complete 5-10 days IV - nonvalv: 60mg qd - do not use in crcl above 95 or less than 15

Therapeutic Dosing (3 decks)

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