Venous Thromboembolism

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Author:
giddyupp
ID:
50563
Filename:
Venous Thromboembolism
Updated:
2011-01-13 11:36:01
Tags:
Venous Thromboembolism PHPR522
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Description:
Venous Thromboembolism
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  1. What are the drug-related risk factors for developing a clot?
    estrogen-type drugs (OC, HRT, SERMs)
  2. What parameter is monitored for heparin?
    • aPTT = 25-35 seconds
    • CBC w/platelets
  3. What parameter is monitored for LMWH?
    • anti-Xa = 0.5-1.0 U/ml (BID), 1-2 U/ml (QD)
    • CBC w/platelets
  4. What is monitored for lepirudin and argatroban?
    • aPTT
    • CBC
  5. What parameters are monitored for warfarin?
    • INR (usually 2-3)
    • CBC
  6. How much vitamin K should be given to a pt who's INR is 3-5?
    none
  7. How much vitamin K should be given to a pt who's INR is 6-9?
    1-2.5 mg PO
  8. How much vitamin K should be given to a pt who's INR is 10-20?
    3-5 mg PO
  9. How much vitamin K should be given to a pt who's INR is > 20 or who is seriously bleeding?
    10 mg IV
  10. What drugs have a significant interaction with warfarin?
    • amiodarone
    • apap
    • fluconazole
    • metronidazole
    • levothyroxine
    • steroids
    • bactrim/septra
    • CBZ
    • phenytoin
    • phenobarb
    • antidepressants
    • FQs
    • macrolides
  11. How do you treat a pregnant woman who needs anticoagulation?
    use heparin
  12. How do you treat a woman who is breastfeeding and needs anticoagulation?
    use warfarin
  13. What is heparin-induced thrombocytopenia?
    • a serious allergic reaction to heparin
    • reduction in platelet count
    • usually occurs 5-14d into tx
    • can cause a clot
  14. How do you treat HIT?
    • d/c heparin
    • use lipirudin or argatroban, or fondaparinux
    • avoid inital use of warfarin d/t risk of venous limb gangrene
  15. What is the recommended duration of warfarin tx for VTE with reversible risk factor present?
    3 mo
  16. What is the recommended duration of warfarin tx for VTE that is idiopathic?
    at least 12 mo
  17. What is the recommended duration of warfarin tx for acute unstable a-fib with cardioversion?
    3 wks before til 4 wks after cardioversion
  18. What is the duration of warfarin tx for prevention of recurrent DVT/PE, thrombosis in chronic a-fib, or thrombosis in prosthetic heart valves?
    lifetime
  19. What is the recommended plan for heparin prophylaxis?
    5000 units SQ q 8-12h for at least 5 days and INR is therapeutic for 24h
  20. What is the recommended plan for LMWH prophylaxis?
    40mg SQ qd for at least 5 days and INR therapeutic for 24h
  21. What is the recommended plan for LMWH tx?
    1 mg/kg SQ bid at least 5d and INR therapeutic for 24h

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