heparin + HIT Flashcards
(27 cards)
What drugs are examples of LMWHs?
Enoxaparin, Dalteparin.
What factor do LMWHs inactivate?
Factor Xa.
What are LMWHs used for?
DVT & PE treatment/prevention (especially post-op), prevent ischemic complications in angina, non-Q MI, STEMI.
Are LMWHs preferred during pregnancy?
Yes.
Do LMWHs require monitoring?
No – fixed dosing.
Where and how are LMWHs administered?
SQ injection in the abdomen – rotate sites.
What are signs of bleeding to monitor for?
Bruising, bleeding gums, abdominal pain, nosebleeds, hematemesis, hematochezia.
What should patients use to minimize bleeding risk?
Electric razor and soft-bristle toothbrush.
What are the adverse effects of LMWHs?
Bleeding, HIT, spinal/epidural hematoma, toxicity (treated with protamine sulfate).
What are some interactions that increase bleeding risk?
Antiplatelet meds, garlic, ginger, glucosamine, ginkgo, saw palmetto.
Is fondaparinux a heparin?
No, but it is heparin-like – activates similar factors.
What factor does fondaparinux inactivate?
Factor Xa.
What are the indications for fondaparinux?
Prevent post-op DVT & PE; treat DVT/PE (with warfarin).
Does fondaparinux require monitoring?
No.
How is fondaparinux administered?
SQ injection – rotate abdominal sites.
What are the common interactions?
Same as LMWHs: antiplatelets, garlic, ginger, glucosamine, ginkgo, saw palmetto.
What are the AEs of fondaparinux?
Bleeding, spinal/epidural hematoma, thrombocytopenia (but not HIT).
When should fondaparinux be discontinued?
Platelets < 100,000/mm³.
What causes HIT?
Autoantibodies to heparin-platelet protein complexes.
When does HIT usually occur?
After ≥4 days of heparin therapy.
What are the key signs of HIT?
Platelets < 150,000 or a ≥50% drop from baseline.
What can HIT lead to?
Venous or arterial thrombosis (venous more common).
Can a patient with HIT ever receive heparin again?
No – considered a lifelong heparin allergy.
What patient education is critical for HIT?
Avoid all forms of heparin/LMWH for life; inform all healthcare providers.
