Heparin, LMWH, and Venous Thromboembolism Prophylaxis

Question 1

AT

Answer 1

antithrombin

Question 2

ACT

Answer 2

activates clotting time

Question 3

iHD

Answer 3

intermittent hemodialysis

Question 4

MACE

Answer 4

major adverse cardiac event

Question 5

TBW

Answer 5

total body weight

Question 6

UFH

Answer 6

unfractionated heparin

Question 7

VTE

Answer 7

venous thromboembolism

Question 8

What is UFH?

Answer 8

Question 9

Draw the diagram of which clotting factors are inhibited by UFH

Answer 9

Question 11

Pharmacokinetics of UFH

Answer 11

Vd is about equal to blood volume. Concentration changes if blood volume changes.

Half-life is does dependent. A good rule of thumb is about an hour.

Question 13

Laboratory monitoring for UFH

Answer 13

aPTT and ACT are functional tests that are affected by other factors. Anti-Xa heparin assay only shows the amount of heparin in the blood, but not how it’s functioning in the patient.

Question 14

Advantages and disadvantages of UFH

Answer 14

Question 15

LMWH available in the United States

Answer 15

Question 16

What is LMWH?

Answer 16

Question 17

MOA of LMWH

Answer 17

Binds to antithrombin and preferentially inhibits Xa and to a lesser extent IIa due to its smaller size

Question 18

Draw the diagram of which clotting factors are inhibited by LMWH

Answer 18

Question 19

Pharmacokinetics for Enoxaparin and Dalteparin

Answer 19

Question 20

Advantages and disadvantages for LMWH

Answer 20

Question 22

Laboratory monitoring for LMWH

Answer 22

Anti-Xa LMWH assay

Question 23

What is Fondaparinux and how does it work?

Answer 23

Question 24

Pharmacokinetics of Fondaparinux

Answer 24

Question 25

Advantages and disadvantages of Fondaparinux

Answer 25

Question 26

BUN

Answer 26

blood urea nitrogen

Question 27

CAD

Answer 27

coronary artery disease

Question 28

H/H

Answer 28

hemoglobin and hematocrit

Question 29

HR-ACT

Answer 29

high range - activated clotting time

Question 30

IU

Answer 30

international units

Question 31

LR-ACT

Answer 31

low range - activated clotting time

Question 32

NSTEMI

Answer 32

non-ST segment elevation myocardial infarction

Question 33

PCI

Answer 33

percutaneous coronary intervention

Question 34

Plt

Answer 34

platelets

Question 35

PT/INR

Answer 35

prothrombin time and international normalized ratio

Question 36

rt-PA

Answer 36

recombinant tissue plasminogen activator

Question 37

SC

Answer 37

subcutaneous

Question 38

SCr

Answer 38

serum creatinine

Question 39

STEMI

Answer 39

ST segment elevation myocardial infarction

Question 40

UA

Answer 40

unstable angina

Question 41

UFH - Initial Dosing

Answer 41

Question 42

UFH - Dosing in Procedures

Answer 42

Question 43

Lab value targets for aPTT and anti-Xa tests

Answer 43

Question 44

Timing of aPTT or anti-Xa draw

Answer 44

Question 45

When to use ACT

Answer 45

Activated clotting time aPTT and anti-Xa tests are not used for high doses of UFH because they lose the ability to accurately display the level of anticoagulation

Question 46

Enoxaparin - Dosing

Answer 46

Question 47

Dalteparin - Dosing

Answer 47

Question 48

Dalteparin - Dosing

Answer 48

Question 49

LMWH Pearls

Answer 49

Question 50

Fondaparinux - Dosing

Answer 50

Question 51

Dosing pearls for Fondaparinux

Answer 51

Question 52

LMWH and Fondaparinux monitoring

Answer 52

Question 53

Question 54

Question 55

Renal dysfunction dosing for UFH, LMWH, and Fondaparinux

Answer 55

Question 56

Anticoagulation therapies in hemodialysis

Answer 56

Question 57

When to consider LMWH for a hemodialysis patient? What is the recommended dose?

Answer 57

Question 58

Dosing of Fondaparinux in renal dysfunction and hemodialysis

Answer 58

Question 59

VTE treatment in morbidly obese

Answer 59

The max dose on Dalteparin should be disregarded

Question 60

VTE prophylaxis is morbid obesity

Answer 60

Question 61

Morbidly Obesity LMWH pearls

Answer 61

Question 62

Things to consider in underweight patients with heparin

Answer 62