Term
| Warfarin Dose shud be decreased w/ RXs |
|
Definition
[AASS]
-Amiodarone
-Azoles
-Statins
-Septra |
|
|
Term
| Warfarin monitoring = q _____wks |
|
Definition
q 12 wks (recheck in 5 days w/ dose changes)
(metab influenced by VKORC1,Cyp2C9,3A4 genetics) |
|
|
Term
| Warfarin + ASA indicated in |
|
Definition
-S/P ACS
-Mechanical Hrt Valve
(inc bleeding risk) |
|
|
Term
| Warfarin alone better than aspirin alone for |
|
Definition
|
|
Term
| Vegetarians have inc intake of |
|
Definition
| Vitamin K----a clotting factor |
|
|
Term
|
Definition
INR less than 2
INR 2-2.5 (strt next day)
{Xarelto strt when INR<3} |
|
|
Term
|
Definition
|
|
Term
|
Definition
| when next LMWH dose is due |
|
|
Term
DOAC to WARFARIN WHEN????
DOAC to LMWH WHEN???? |
|
Definition
DOAC to WARFARIN WHEN????
DOAC taken simultaneous till INR range reached (bridging)
DOAC to LMWH WHEN????
when nxt dose of DOAC due |
|
|
Term
Low risk bleeding
HIGH RISK BLEEDING |
|
Definition
Hold DOAC 24 hrs prior w/ LOW
_HOLD DOAC 48 hrs prior w/HIGH |
|
|
Term
These Risks are
Cath ablation/electro study
Endoscopy w/biopsy
prostate/bladder biopsy
Angiography
Pacemaker/ICD implant(unless CHD) |
|
Definition
|
|
Term
These Risks are
Complex left sided ablation
spinal/epidural anasthesia
thoracic,ab,or major orthoped surgery
Liver/Kidney biopsy |
|
Definition
|
|
Term
Signs and symptoms of bleed
HCT=
Platelet= |
|
Definition
HCT= <30%
Platelet=<100,000 or 50% below baseline
New back,flank, groin pain
Melena,etc |
|
|
Term
|
Definition
CBC
Pt/INR and PTT, Weight/Height |
|
|
Term
HEPARIN ongoing monitor CBC q
anti Xa |
|
Definition
CBC check= q 1 to 3 days
anti Xa= 6 to 8 hrs after bolus and initial infusion/dose change til therapeutic(once daily therafter) |
|
|
Term
| LMWH be careful with _____dosing |
|
Definition
Renal
(Enoxaparin<30ml/min reduce dose) |
|
|
Term
|
Definition
CBC
Pt/INR and PTT, Weight/Height
Basic metabol panel |
|
|
Term
LMWH ongoing monitor CBC q
anti Xa |
|
Definition
CBC= 1st 14 days
(q 1-2 days in pt.2-7 days out pt)
Bone density in tx >3mnths
(AntiXa=indicated pops) |
|
|
Term
| DO NOT USE THIS LMWH IN CrCl <30mL/min |
|
Definition
|
|
Term
|
Definition
Quinidine, procainamide
-Na+ blockers |
|
|
Term
|
Definition
Lidocaine, Mexiletine
-Na+ blockers
-Slows conduction Velocity/inc recov period |
|
|
Term
|
Definition
Flecanaide, Propafenone
-Na+ blockers
-SLow conduc velocity/inc recov period |
|
|
Term
|
Definition
Metoprolol, Atenolol
-Beta Blockers |
|
|
Term
|
Definition
Dofetilide, Amiodarone,Dronedarone, Sotalol, Ibutilide
-K+ Blockers [prolongs refrac period/delays repolarization] |
|
|
Term
|
Definition
Verapamil, DILTIAZEM
-CCBs
[prolong repolztn at AV node,dec cond velocity] |
|
|
Term
|
Definition
Digoxin, Mg2+, Adenosine
-Miscellaneous |
|
|
Term
| Lidocaine (Xylocaine) Indication |
|
Definition
|
|
Term
|
Definition
K & Mg
Serumlidocaine (2-6ug/ml) |
|
|
Term
| Flecanaide (Tambacor) Indication |
|
Definition
|
|
Term
|
Definition
ECG
K & Mg
SCr
Serum rx conc (0.2-1mcg/mL) |
|
|
Term
| Amiodarone (CORDARONE) Indication |
|
Definition
|
|
Term
|
Definition
|
|
Term
| SOTALOL (Betapace) Indication |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Dofetilide (Tikosyn) indication |
|
Definition
AF
[monitor ECG,Renal func, K&Mg] |
|
|
Term
Dronedarone (Multaq) indication/monitr\
[Take w/ food] |
|
Definition
Paroxysmal AF
Monitor---ECG,LFTs, MG & K+ |
|
|
Term
| Diltiazem (Cardizem) &Verapamil (CALAN) indication/monitr |
|
Definition
|
|
Term
|
Definition
AF
Monitor ECG,K&Mg,renal func
trough Digoxin levels 0.5-2ng/mL |
|
|
Term
|
Definition
|
|
