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Indications for warfarin?
- Prevention and treatment of VTE
- Prevention of thromboembolism in pateints with heart valves
- Prevention of stroke in patients with previous MI
Precautions of warfarin?
Protein C or protein S deficinency - increased risk of skin necrosis
Adverse effects of warfarin?
skin necrosis, hair loss, nausea, vomiting,
Dose of warfarin?
Usually 5mg once daily then adjust
usually 1-10mg daily.
Counselling for warfarin?
Always take the same brand of tablets
Avoid cranberry juice in excessive amounts
Tell your doctor if you develop a painful purple bruise-like rash
Maintain a consistent diet
Tell other medical professionals you are taking warfarin
Look out for unexplained burising, or bleeding, red or dark brown urine or dark coloured faeces
Indications of dipyridamole?
Prevention of thromboembolism in patients with prosthetic heart valves (with warfarin)
Secondary prevention of ischaemic stroke and TIA, including combination with aspirin
Precautions of using dipyradimole?
Treatment with other blood thinners
Adverse effects of dipyridamole?
headache, diarrhoea, nausea, vomiting, hot flushes, hypotension, tachycardia
Dose of dipyridamole?
secondary stroke prevention?
thromboembolism prevention - 300–600 mg daily in 3 or 4 doses.
Secondary prevention of stroke and TIA -Controlled release, oral 200 mg twice daily.
Counselling for dipyridamole?
This medicine is absorbed best if taken on an empty stomach 1 hour before, or 2 hours after, meals.
If it upsets your stomach, it can be taken with food or milk.
Some people get a bad headache with this medicine, especially at the start of treatment; tell your doctor if this happens to you.
Indications for enoxaparin?
Prevention of VTE in surgical patients and in medical patients bedridden due to acute illness
Treatment of venous thrombosis
Treatment of acute STEMI, non-STEMI and unstable angina
Precautions of enoxaparin?
caution in renal impairment, reduce dose if crcl < 30mL/min
increased risk of bleeding
Adverse effects of enoxaparin?
bleeding, bruising and pain at injection site
Dose of enoxaparin?
for VTE treatment?
SC, 1 mg/kg twice daily for 5- 10 days
Counselling for enoxaparin?
tell your doctor if you have any signs of bleeding or unexplained bruising
Precautions of using clopidogrel??
Metabolised by cyp to active form. Avoid use with cypc19 inhibitors
Adverse effects of clopidogrel?
Dose of clopidogrel?
75mg daily for antiplatelet activity
ACS - 300mg loading dose then 75mg maintainance for upto 12 months
Indications for prasugrel?
Prevention of atherothrombotic events (with aspirin) in acute coronary syndromes (including STEMI and non-STEMI) to be managed with PCI
Precautions of prasugrel?
- History of stroke or TIA -- contraindicated
- Elderly -- high risk of bleeding
Adverse effects of prasugrel?
Dose of prasugrel *with asprin*
60mg then 10mg daily