anticoagulation

Question 1

Eliquis

Answer 1

apixaban

Question 2

Xarelto

Answer 2

rivaroxaban

Question 3

Pradaxa

Answer 3

dabigatran

Question 4

anti-platelet

Answer 4

clopidogrel, ticagrelor (P2Y12i), aspirin

Question 5

UFH dose for VTE prophylaxis

Answer 5

5000 units SC q8-12hr

Question 6

UFH dose for VTE treatment

Answer 6

80 units/kg bolus IV ; 18 units/kg/hr infusion

Question 7

which anticoagulant causes hyperkalemia

Answer 7

UFH

Question 8

Lovenox

Answer 8

enoxaparin (LMWH)

Question 9

LMWH: prophylaxis dose for VTE

Answer 9

30mg SC Q12hr or 40mg SC QD (if CrCl <30 = 30mg SC QD)

Question 10

LMWH: treatment of VTE, UA, NSTEMI

Answer 10

1 mg/kg SC Q12hr or 1.5 mg/kg SC daily (inpatient VTE treatment only) (CrCl<30 = 1 mg/kg SC QD)

Question 11

LMWH: treatment for STEMI <75 yo

Answer 11

30 mg IV bolus + 1mg/kg SC dose (same if CrCl <30)

Question 12

thrombocytopenia

Answer 12

unexplained >50% drop in PLTs

Question 13

Savaysa

Answer 13

edoxaban

Question 14

used off-label for HIT

Answer 14

fondaparinux

Question 15

apixaban: non valvular AF stroke prophylaxis

Answer 15

5 mg PO BID

Question 16

apixaban 2.5 mg PO BID if:

Answer 16

2 of the following: 80 yo, 60kg, SCr 1.5

Question 17

apixaban: treatment of VTE

Answer 17

10 mg PO BID x7 days, 5 mg PO BID

Question 18

Xarelto: non valvular AF (stroke prophylaxis)

Answer 18

take with evening meal

Question 19

Xarelto: VTE treatment

Answer 19

15 mg PO BID x21 days, 20 mg PO QD

Question 20

renal CI of fondaparinux

Answer 20

CrCl <30

Question 21

apixaban and rivaroxaban are substrates

Answer 21

Pgp, 3A4

Question 22

Pradaxa

Answer 22

dabigatran

Question 23

don’t put this in NG tube

Answer 23

dabigatran

Question 24

lower doses of warfarin in (6)

Answer 24

elderly, malnourished, taking drugs that inc warfarin levels, liver disease, heart disease, inc risk of bleeding

Question 25

CYP2C9 inhibitors

Answer 25

fluconazole, bactrim, flagyl, amiodarone (when starting dec warfarin dose by 30-50%)

Question 26

what drugs increase clotting risk

Answer 26

SERMs, estrogen

Question 27

natural products that increase bleed risk (6)

Answer 27

vitamin E, willow bark, chondroitin, dong quai, high doses fish oil, 5 g's

Question 28

max dose of protomine

Answer 28

50mg

Question 29

Mephyton

Answer 29

vitamin K (phytonadione)

Question 30

Kcentra

Answer 30

four factor prothrombin complex concentrate (human)

Question 31

Balafaxar

Answer 31

four factor prothrombin complex concentrate (human)

Question 32

disease states that is RF for thromboembolism

Answer 32

respiratory illness, heart failure, nephrotic syndrome

Question 33

UFH: treatment of ACS/STEMI

Answer 33

60 units/kg IV bolus; 12 units/kg/hr infusion