Rxprep- Anticoagulant Questions and Answers |
Revised !!
vitamin K given IV has a risk for this adverse reaction________ - answer- anaphylaxis(
dyspnea, cardiac arrest, hypotension, shock)
immobility and obesity are risk factors for ____________ - answer- DVT
if patient is started on enoxaparin, which laboratory test to monitor efficacy therapy? -
answer- routine monitoring of enoxaparin with anti-Xa levels is not necessary but can
be done in certain patients. Peak Anti-Xa level should be drawn 4 hours after SQ
dose( peak)
oral anticoagulants for DVT treatment because it does not require monitoring which
ones - answer- pradaxa, eliqiuis, xarelto
warfarin should be started on the ___________ as parenteral anticoagulant (LMWH or
UFH) for DVT/PE.
Parenteral anticoagulant must be used in a treatment dose not prophylactic dose:
if patient weighs 90k, which option would you pick
1) lovenox 90mg SC Q 12 H
2) Heparin 5000 U SQ 8 H - answer- 1) lovenox 90mg SC Q 12 H because treatment
of VTE/and UA and NSTEMI for lovenox is 1mg/kg/ SC Q 12H and if crcl is less than
30, use 1mg/kg/ SC DAILY
CORRECTION
Heparin 5000 U SC 8 H ==> This is wrong because this prophylatic dose and we're
trying to treat
which foods are high in vitamin K - answer- brocoli
brussel sprouts
cabbage
canola oil
cauliflower
chickpeas
, cole slaw
collard greens
coriander
endive
green kale
lettice ( red leaf or butterhead)
mustard green
parsley
soybean oil
spinach
swiss chard
tea- green or black
turnip greens
watercress
INR is 3.5. what to do - answer- phytonadione is not recommended for INR less than
4.5 Just hold the warfarin dose for that day, resume usual dosing regimen when INR is
therapeutic and have patient monitor for sign of bleeding
what scenarios do we monitor for LMWH - answer- 1) preggo with PE
2) preggo with mechanical heart valves
3) severe weight- obesity vs low body weight
4) severe renal impariemnt
5) pediatricts or elderly
what 2 routes can heparin be given ? - answer- ONLY IV OR SC
RISK of IM ADMINISTRATION: IM injection of heparin can cause risk of hematoma
formation and pain
overdose of heparin antidote - answer- protamine
dalteparin is a ______ and brand name is - answer- LMWH
Fragmin
patient has a PE and was started on enoxaparin therapy. The MD began warfarin
therapy and wrote an order to DC the enoxaparin the following day, was his action
inappropriate - answer- it was not appropriate because in patient with acute DVT/PE,
and was started on warfarin on the same day as parenteral anticoagulant ( enoxaparin
or UFH), continue both anticoagulant for a MINIMUM OF 5 DAYS and until INR IS
MORE THAN 2 FOR A T LEAST 2 HOURS
Which anticoagulants carry spinal or epidural hematoma risk? - answer- only LOW
MOLECULAR WEIGHT HEPARINS, Xa inhibitors and dabigatran
Revised !!
vitamin K given IV has a risk for this adverse reaction________ - answer- anaphylaxis(
dyspnea, cardiac arrest, hypotension, shock)
immobility and obesity are risk factors for ____________ - answer- DVT
if patient is started on enoxaparin, which laboratory test to monitor efficacy therapy? -
answer- routine monitoring of enoxaparin with anti-Xa levels is not necessary but can
be done in certain patients. Peak Anti-Xa level should be drawn 4 hours after SQ
dose( peak)
oral anticoagulants for DVT treatment because it does not require monitoring which
ones - answer- pradaxa, eliqiuis, xarelto
warfarin should be started on the ___________ as parenteral anticoagulant (LMWH or
UFH) for DVT/PE.
Parenteral anticoagulant must be used in a treatment dose not prophylactic dose:
if patient weighs 90k, which option would you pick
1) lovenox 90mg SC Q 12 H
2) Heparin 5000 U SQ 8 H - answer- 1) lovenox 90mg SC Q 12 H because treatment
of VTE/and UA and NSTEMI for lovenox is 1mg/kg/ SC Q 12H and if crcl is less than
30, use 1mg/kg/ SC DAILY
CORRECTION
Heparin 5000 U SC 8 H ==> This is wrong because this prophylatic dose and we're
trying to treat
which foods are high in vitamin K - answer- brocoli
brussel sprouts
cabbage
canola oil
cauliflower
chickpeas
, cole slaw
collard greens
coriander
endive
green kale
lettice ( red leaf or butterhead)
mustard green
parsley
soybean oil
spinach
swiss chard
tea- green or black
turnip greens
watercress
INR is 3.5. what to do - answer- phytonadione is not recommended for INR less than
4.5 Just hold the warfarin dose for that day, resume usual dosing regimen when INR is
therapeutic and have patient monitor for sign of bleeding
what scenarios do we monitor for LMWH - answer- 1) preggo with PE
2) preggo with mechanical heart valves
3) severe weight- obesity vs low body weight
4) severe renal impariemnt
5) pediatricts or elderly
what 2 routes can heparin be given ? - answer- ONLY IV OR SC
RISK of IM ADMINISTRATION: IM injection of heparin can cause risk of hematoma
formation and pain
overdose of heparin antidote - answer- protamine
dalteparin is a ______ and brand name is - answer- LMWH
Fragmin
patient has a PE and was started on enoxaparin therapy. The MD began warfarin
therapy and wrote an order to DC the enoxaparin the following day, was his action
inappropriate - answer- it was not appropriate because in patient with acute DVT/PE,
and was started on warfarin on the same day as parenteral anticoagulant ( enoxaparin
or UFH), continue both anticoagulant for a MINIMUM OF 5 DAYS and until INR IS
MORE THAN 2 FOR A T LEAST 2 HOURS
Which anticoagulants carry spinal or epidural hematoma risk? - answer- only LOW
MOLECULAR WEIGHT HEPARINS, Xa inhibitors and dabigatran
