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314
Pharmacology
11th Grade
09/18/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
parcopa is 
Definition
sinemet odt
Term
mirtazepine odt is called
Definition
remeron soltab
Term
name the migraine odt
Definition

maxalt MLT(rizatriptan)

zomig ZMT (zomitriptan)

Term
odt formulation are use for what kind of patients
Definition

dysphagia

trouble swallow (small children)

ADHD

 

Term
HLA B 5701 is genetic testing for?
Definition
ziagen (abacavir)
Term
HLA B 1502 is tested for 
Definition

carbamazepine

(sjs)

Term
HLA 5801 is test for 
Definition

allopurinol

(severe cutaneous reaction)

Term
when codeine cause pain and cough test for
Definition
drug with 2d6 inhibitor
Term
TPMT is tested for 
Definition

azathioprine

mercaptopurine

(risk of mylosuppresion)

Term
UGT1A1*28 is tested for 
Definition

irinotecan(campostar)

increase risk of neutropenia

Term
peanut allergy
Definition

propofol

clevidipine

ipratropium

 

 

Term
egg allergy
Definition

clevidipine

propofol

flu shots

Term
name the common photosensitivity drugs
Definition

DIM IRAQ (IRAN)

sulfa antibiotics

tetracyclines

Nsaid

metronidazole

isoniazid

quinolones

azole antifungal

diuretics

isotretinoin

ritonavir

Term
women of child bearing age and supplements
Definition

folic acid 400mcg

calcium 100 

vitamin d 600

Term
prenatal vitamin usally contain how much folic
Definition
1 mg
Term
natural products that increase bleeding
Definition

DEFFGGGG

dong quai

vitamin E

FeverFew

fish oil (over three grams)

ginger

ginseng

ginkgo

garlic

Term
natural products that may be hepatoxic
Definition
kava,comfrey,chaparrel
Term
milk thistle
Definition
use for liver
Term
saw palmetto is use for
Definition
prostate enlargement
Term
natural product for cold flu
Definition

echinacea

zinc

vitamin c

Term
vitamin d intake
Definition

adult 600 iu

>70 800 iu

 

Term
other names for vitamin D3
Definition
cholecalciferol
Term
poly vi sol is 
Definition
vitamin for babies and chldren
Term
amiodarone: what out for what drugs when taking together
Definition

decrease amio:

digoxin

warfarin

quinidine

procainamide

(increase bleeding and Qt prolongation)

decrease: statin

Term
Azole antifungal drug interaction
Definition

increase 3a4

increase ph decrease absorbtion

 

Term
clopidogrel drug interaction: which drugs to avoid
Definition

cyp2C19

 

cimetidine

espmeprazole

etravirine

efavirenz

fluoxetine

fluvoxamine

ketoconazole

modafinil

omeprazole

topiramate

voriconazole

 

Term
colchicine drug interaction: avoid which drugs
Definition
strong 3a4
Term
digoxin drug interaction: avoid which drugs
Definition

mostly renally cleared

hypokalemia

decrease dig: cholestryamine,colestipol,metoclopramide

increae dig:

antiarryth, and other renal cleared drugs

Term

drug interaction with 

valproate and lamotrigine

 

- risk?

Definition
severe rash so titrate slowly
Term

lithium risk?

increase when?

decrease when?

 

Definition

100% renally cleared

 

increase when: decrease salt, Nsaid,ace,arb,dehydration

decrease when: inc na,caffeine,theophylline

 

 

Term
drugs that decrease OC
Definition

antibiotics

anticonvulsants

st john wort

HIV (PI,nevirapine)

smoking

Term
tamoxifen do not use with
Definition
2d6 inhibitor (antidepressents)
Term
avoid __ when taking tetracycline and quinolone
Definition

al,mg,ca,iron,zinc (decrease absorbation)

 

Term
drugs that increase theophyline
Definition
cyp 1a2, 3a4
Term
drugs with hyperkalemia risk
Definition
ace,arb,k sparing,yasmin
Term
cns depression side effect drugs
Definition
alcohol,opiod,nsaid,muscle relaxants,benzo,barbit,hypnotics,mirtazapine,trazodone,dronabinol,nabilone,proranolol,clonidine
Term
drugs with qt risk
Definition

class I,III

quinolone

macrolide

TCA

antipsychotics

apomorphine

droperidol

foscarnet

methadone

pentamidine

Term
therapeutic range for carbamazepine
Definition
6-12 mcg/ml
Term
therapeutic range for levothyroxine
Definition

FT4 .8-1.7

TSH .3-3

Term
therapeutic range for lithium
Definition
.6-1.2 meq/L
Term
therapeutic range for phenytoin
Definition
10-20 mcg/ml
Term
therapeutic range for theophyline
Definition
5-15 mcg/ml
Term
theraputic range for digoxin
Definition
.8-2.0 ng/ml
Term
therapeutic range for valproate acid
Definition
50-100 mcg/ml
Term
aminoglycoside is dose using what type of body weight
Definition
IBW
Term
Tobi must be used with what kind of inhaler
Definition
Pari-LC PLUS Nebulizer
Term
black box for AMG
Definition

neurotoxcity

nephrotoxicity

Term
pregnancy catagory for AMG
Definition
D
Term
when to get level for traditional dosing of AMg
Definition

trough:right before the next dose

peak: 1/2 hours after the end of drug infusion

 

Term
when to draw level for extended interval dosing of AMG
Definition

draw random level withing 8-12 hours post dose

determine frequency using nomogram

Term

dosing concentration for AMG

gentamycin

tobramycin

Amikacin

Definition

gentmycyn: peak 5-10, trough <2

tobramycin:peak 5-10, trough <2

amikacin: 20-30, trough <5

Term

benefits of extended interval over traditional dosing of AMG

 

Definition

less nephro

more cost effective

Term
how to take moxatag with regard to meal
Definition
take within i hr of finishing a meal
Term
what drug class alter the coombs test
Definition
cephalosporins
Term
drug that increase beta lactam level
Definition
uricosuric agent (probenacid,allopurinal)
Term
which drug class cuase false positive glucose test
Definition

pcn

cephalosporins

Term
which carbopenem increase seizure
Definition
imipenem
Term
what is primaxin
Definition
imipenem/cilastin
Term
what is invanz
Definition
ertapenam
Term
what to know about cipro and NG tube
Definition

do not use cipro oral solution

use immediate relase, crush it (hold feeding 1 hours before 2 hours after)

Term

what is proquin XR

how to give it interms of food

Definition

ciprofloxacin

give with main meal

 

Term
which quinoline does not have renal adjustment
Definition
moxifloxacin
Term
chelation with quinolones
Definition

separate 2 hours before and 4-6 hours after

proquin 4 hours before and 6 after

Term
Azithromycin oral suspension storage
Definition
do not refridge Zmax
Term
Biaxin storage
Definition
do not fridge
Term
erythrylmycin EES storage
Definition
must fridge
Term
do we restore azasite once it is open out of the fridge
Definition
no
Term

Oracea is brand for

how to give it

Definition

doxycycline

empty stomach (one hours before and 2 hours after meal)

Term
bactrim suspension storage
Definition
room temp
Term
bactrim IV is good for__ once diluted
Definition
6 hours
Term

max rate for vanco

max concentration

Definition

at least 30 min/500mg

max concentration 5mg/ml

 

Term
oral suspension for linzolide storage
Definition
room
Term

side effect for linezolid

does it require renal adjustment

Definition

mylosuppresion

avoid tyramine

no renal adjustment required

Term

syncerid must be diluted in

does it require renal adjust? 

Definition

D5W, at least 250ml

no renal adjust

Term
daptomycin must dilute in 
Definition
NS only
Term
black box for telavancin
Definition

vibativ

BBW: fetal risk, obtain pregnancy test

Term
daptomycin require monitoring of 
Definition
CPK weekly
Term
cayston is used for
Definition

aztreonam,

inhaled use for CF

Term
BBW for chloramphenicol
Definition

aplastic anemia, thrombocytopenia

 

its an antibiotic

Term

what is ketek

black box?

what does it cause

Definition

telithromycin

do not use in myathenia gravis, cause respiratory failure

cause visual disturbance

 

 

Term
FDA Alert for Tygacil
Definition

tegecycline

 

increase death when tx in serious infection

Term
black box for clindamycin
Definition
severe colitis
Term
how to take metronidazole extended release
Definition

take on empty stomach

 

avoid acohol

Term

tinidazole

how should you take it

Definition

tindamax

 

take with food to decrease gi

 

Term
UTI tx during in pregnancy
Definition
7 days
Term

tx duration of pyelonephritis

when use FQ, ceftriaxone

Definition

fQ 5-7

cetriaxone 14 days

Term
complicated uti tx duration
Definition
2-3 weeks
Term
when to avoid phenazopyradine
Definition
crcl <50 ml/min
Term
what formulation is penicillin G benazthine
Definition
IM
Term
what formulation is penicillin procaine
Definition
IM
Term
what formulation is penicillin G (aquous)
Definition
IV
Term
if a patient is alergic to acyclovir, what is the alternative
Definition
foscarnet
Term
TB test should check for induration withing
Definition
48-72 hours
Term
latent TB tx for how long
Definition
9 months
Term
how much b6 to give with isoniazid
Definition
25-50mg/daily
Term

isoniazid

take with food/empty

Definition
empty
Term
store isoniazid solution in 
Definition
room
Term
black box for isoniazid
Definition
severe hepatitis
Term

rifampin

with food or empty

Definition
empty
Term
side effect of ethambutol
Definition

myambutol

decrease vision

Term
what is the observation period duration for otitis media?
Definition
48-72 hours
Term
what is auralgan
Definition
topical benzocaine
Term
what is americaine otic
Definition
topical benzocaine
Term
if could not use amox for otitis, name other agents
Definition

ceftdinir

cefpodoxime

cefpodoime

cefprozil

cefuroxime

Term
patient who are allergic pcn in otitis media, choose another agent
Definition

azithromycin

clarithromycine

bactrim

erythromycin-sulfisoxazole

 

Term
pediazole is
Definition

erythromycin-sulfisoxazole

 

Term
prevnar is 
Definition

pneumococcol vaccine in children 2-23 months

given 4 doses (ages 2,4,6,12-15 months)

 

also cover meningitis

Term

dental prophy

primary

alternative

Definition

primary: amox 2g

alternative: 

cefazolin

clindamycin

azithromycin

Term
gentamycin do not exceed concentration of 
Definition
4mcg/ml
Term
symptoms of menningitis
Definition

fever

rigidity

and alter mental status

Term
all ricketsial disease is tx with doxy except
Definition

tularemia

tx with gent/tobra

Term
which agent fluconazole wont tx
Definition

c. krusei

c. glabrata

Term
ampho should be premediate with
Definition

apap

nsaid

diphen

meperidine (reduce rigors)

saline boluses (reduce of nephrotox)

Term
ampho B and electrolytes
Definition
cuase hypokalemia
Term
flucytosine (5-FC) is used to 
Definition

synergy with AmphoB 

down side "bone marrow suppression"

Term

itraconazole

fluconazole

ketoconazole

(food/empty)

 

Definition

take with food

requires acidity for absorbtion

Term

intraconazole 

oral suspension vs capsule

Definition

can not be used interchangebly 

not bio eqivalent

Term

oral solution itraconazole

food/empty

Definition
empty stomach
Term
itraconazole black box
Definition

capsule should not use for onchyomycosis

do not admin with cisapride,dofetilide,pimozide,quinidine

Term
iv/po fluconazole
Definition
1:1
Term
black box for ketoconazole
Definition

-do not admin with cisapride cause arrhythmias

- hepatotoxicity

Term

voriconazole

food/empty

Definition
one hour before and two hours after meal
Term
voriconazole is CI in
Definition
3a4 subtrate
Term
name the common 3a4 substrate
Definition
Term
electrolytes to watch out for in voriconazole
Definition

correct K,mg,ca

monitor liver

Term

what agent cover 

c. krusei

c.glabrata

Definition
voriconazole
Term
side effect of voriconazole
Definition

avoid night driving

avoid sunlight

Term

posaconazole

food/empty

Definition

noxafil

must be taken with full meal

 

Term
all azole are ___ inhibitors
Definition

3a4

(voriconazole is strongest CI)

Term

itraconazole and ketoconazole

PH concerns

Definition
higher ph, lower absorbtion
Term

caspofungin

dilution fluid

Definition
NS only
Term
indication for micafungin and dose
Definition

Mycamine

 

candidemia

100mg IV

esophageal candidias

150 IV over 60 minuts

Term

anidulafungin indication

 

do not exceed dose

Definition

Eraxis

 

esophageal 

100mg LD iv on day 1, then 50mg qd

candidemia

200 iv LD, then 100 iv qd

do not exceed 1.1mg/min

Term

aspergillus 

cuase which organ disease

Definition
pulmonary
Term

tx for candida albican

what is the duration

Definition
2 wks after the last positive culture
Term

oral candidiasis

non aids vs aids

Definition

aids tx

ampho B: .3mg/kg IV qd

7-14 days

Term
esophageal candidiasis tx
Definition

ampho B 

.5mg/kg qd

 

14-21 days

Term

C. glabrada 

C. krusei

Definition
blood stream candida albican
Term
When to use KOH test
Definition

superficial fungal infection 

vaginal infection

Term

vaginal Candida infection

cause?

symptoms

tx

duration: preg,recurrent,

 

Definition

cuase by morbid disease

symptoms: puritis,curd like vaginal discharge

tx: topical azole, 

severe or preg: 7 days

recurrent (>4 episodes/year): 7-14days

Term

-vaginal candida infection

diabetest and HIV pt should

- first timer

Definition

see a doctor

 

Term
patient counseling for topical antifungal
Definition

apply night before bed

weaken condoms

if recurs within two months after using otc, see a doctor

Term
acyclovir are usual frequency
Definition
2-5 times daily
Term

azithromycin

IR/ER (food/empty)

Definition

IR: with or without

ER: empty stomach

Term
cipro do not take with
Definition
tizanidine
Term
tamiflu should be treated within__ days
Definition
2 days
Term
when taking nitrofurantoin, avoid
Definition
antacids
Term
terbinafine tx duration for onchymycosis
Definition

several months

vision change

Term
valtrex should be taken___ hrs of outbreak
Definition
within 24 hours of outbreak
Term
valtrex suspension discard after
Definition
28 days
Term

Voriconazole

tablet contain what ingrediant

Definition

lactose

 

do not use if pregnant

Term
initial viral therapy when CD4 is 
Definition
< 350
Term
increase viral load , decrease cd4 indicates
Definition
drugs resistance
Term
art patient with HIV rna >1000 indicates
Definition
tx failure
Term
epzicom 
Definition

abacavir

lamivudine

Term
Trizivir
Definition

abacavir

lamivudine

zidovudine

Term
black box for didanosine
Definition
pancreatitis
Term
Truvada
Definition

emtricitabine

tenofovir

Term
atripla
Definition

emtricitabine

tenofovir

efavirene

Term
black box for stavudine
Definition
pancreatitis
Term
black box emtricitabine
Definition
may exacerbate hep B 
Term
black box for lamivudine
Definition
do not use epivir-HBV for tx of HIV
Term
black box for tenofovir
Definition
may exacerbate Hep B once drug is d/C
Term

how to take efavirenz

food/empty

Definition
empty stomach at bedtime (huge CNS)
Term

how to take delavirdine

(ph)

Definition
take with acidic beverage
Term
black box for nevirapine
Definition

hepatoxicity

sjs

 

3a4 inducer

Term

atazanavir 

food/empty

Definition

with food

avoid PPI

Term

darunavir

food/empty

Definition
with food
Term

indinavir 

food/empty

Definition
with food
Term

which antiviral contain 40% alcohol

food/empty

Definition

ritonavir

 

take with food

Term

kaletra

solution (food/empty)

Definition
with food
Term

saquinavir

food/empty

Definition
take within 2 hours of full meal
Term
tipranavir black box
Definition

hepatitis

intracranial hemorrage

Term

fuzeon

how to prepare solution

Definition
refridge and use within 24 hours
Term
know neu to myco
Definition
Term
black box for selzentry
Definition

hepatotoxicity

 

Term

metformin and IV contrast dye

 

Definition
hold dye and wait 48 hours after procedure before initiate metformin
Term
be careful of sulfonurea with
Definition
alcohol cause hypotension
Term

take meglitanide 

(food/empty)

Definition

15-30 minute before

no food no drug

Term
do not use exanitide if 
Definition

prancreatitis

gallstones

alcoholism

Term
when to inject exanitide
Definition
before morning and evening meal
Term
black box for victoza
Definition
CI in pt with his of Medullary thyroid carcinoma
Term
welchol is contraindicated when...
Definition
TG>500, or history of induce pancreatitis
Term
dosing of welchol
Definition
6 tabs daily or 3 bid
Term

bromocriptine

food/empty

Definition
food
Term
NPH risk of hpoglycemic when
Definition
afternoon
Term
what is fentora
Definition
sublingual fentanyl
Term
dose for tylenol infant drop
Definition

80mg/.8 ml

 children 160mg/5ml

Term

ibuprofen 

OTC vs RX

Definition

OTC: 200-400

RX: 600-800

Term

naproxen 

otc vs rx

Definition
otc: 220 (aleve)
Term
max dose for naproxen
Definition
440mg/day
Term
what is vimovo
Definition

naproxen with esomeprazole

(ppi protect gut)

Term
name the selective nsaid
Definition

ce-men

celecoxib

meloxicam

nabumatone

etodolac

Term

nsaid can increase

which vital 

Definition
bp
Term
DSS is 
Definition
docusate sodium
Term
avinza special instruction
Definition

no alcohol

can sprinkle in applesauce

Term

what is relistor

formulation

Definition

methylnaltrexone

sq

opioid resistant laxative

Term
what is embeda
Definition

morphine/naltrexone

deter abuse

Term

kadian

special instruction

Definition
can be open and put down NGT or sprinkle in apple sauce
Term
if allergic to morphine, choose
Definition

fentanyl

meperidine

methadone

tramadol

Term

morphine frequency

IR

ER

Avinza

 

Definition

ir: 10-30 q4

ER: up to 200 Q8-12

Term
fentanyl is contrainidated when
Definition
opioid naive
Term
actiq is
Definition
fentanyl SL lozenge
Term
how to remove fentanyl
Definition

do not use soap, use water

flush in toilet

Term
exalgo is 
Definition
hydromorphone extend release
Term
hydromorphone come in what dose
Definition
2,4,8
Term
exalgo need washout with
Definition
maoi
Term

oxymorphone

food/empty

Definition
take on empty ( most other analgesic are with food)
Term
duration of action of merperidine
Definition
3 hours
Term
meperidine avoid in 
Definition

elderly due to renal

serotonin syndrome

Term
side effect of tramadol
Definition

seizure

serotonin

Term
nucynta is
Definition
tepentadol
Term

embeda

should avoid

Definition
alcohol can cause dealth
Term

butrans

do not (dose)

wear patch for __ days

Definition

buprenorphine patch

exceed 20mcg/hour

 wear patch for 7 days

Term

to prescribe suboxone 

dea ends with

Definition
X
Term
what is buprenex
Definition

buprenorphine 

injection

Term
dose for carisoprodol
Definition
250-350 QID prn
Term
dose for baclofen
Definition
5-20mg QID prn
Term
dose for cyclobenzaprine
Definition
5-10mg TID prn
Term
metaxalone
Definition
800 QID prn
Term
methobamol
Definition
1500-2000 qid prn
Term
tizanzidine
Definition
Qid max 3 grams
Term
voltaren gel is
Definition
diclofenac
Term
flector patch is
Definition
diclofenac 
Term
capsaicin take how long to work
Definition
2-4 weeks
Term
how often to apply capsaicin
Definition
3 to 4 times
Term
methadose is
Definition
liquid methadone
Term
sublimaze is 
Definition
fentanyl injection
Term
signs and symptoms of overdose narcan
Definition

somnolence

respiratory depression

pinpoint pupil

miosis

Term
side effect of snri
Definition

increase bp

sexual side effects

Term
specific side effect of duloxetine
Definition

drug mouth

somnolence

decrease appetite

Term
side effect of TCA
Definition

cardiotoxicity

anticholinergics

Term
specific side effect of pregabalin
Definition

mild euphoria

blurred vision

weight gain

Term
glutethimide is controlled
Definition
II
Term
drug with pectins are contolled
Definition
V
Term
pediacof is controlled
Definition
V
Term
cosanyl is controlled
Definition
V
Term
what is bystolic
Definition
nebivolol
Term
what is sular 
Definition
nisoldipine ER
Term
what is dynacirc
Definition
Isradipine ER
Term
revisit ca blocker brand generic
Definition
Term
what is adalact CC
Definition
Nifedipine ER
Term
what is procardia
Definition
nifedipine
Term

Cardene SR vs Cardene

dosing

Definition

SR: BID

IR: TID

Term

side effect methodopa

what test use

Definition

lupus like syndrome

coombs test

Term
what is tribenzor
Definition

amlodipine

omesartan

HCTZ

Term
what is exforge
Definition
amlodipine valsartan
Term
what is ziac
Definition
bisoprolol
Term
what is tarka
Definition

trandolapril

temlisartan

Term
do not use what drug for urgency hypertension
Definition
nifedipine SL
Term
niroglycerin storage
Definition
keep in glass bottle, melt plastic
Term
how much stanols and sterols each day
Definition
2 grams
Term
take simvastatin at what time of day
Definition
bedtime
Term

what is altoprev

give at what time of day

Definition

extended release of lovastatin

take at bedtime

Term
how to take lescol vs lescol XL
Definition

fluvastatin

 

 

XL at anytimes

lescol: take at bedtime

Term
two statin that does not require renal adjust
Definition

lescol

lipitor

Term
what statin can be taken at anytime of day
Definition

crestor

lipitor

livalo

pravachol

Term
statin that most effect by warfarin
Definition
fluvastatin
Term
how to give cholestyramine
Definition

2-4 packets or scoopful daily

mix the power in water

Term
how to give colesevelam
Definition
give with meal and liquid
Term
separate the following drugs with bile acids
Definition

phenytoin

glyburide

warfarin

niaspan

fenofibrate

ADEK (mostly K)

Term
max gram for colestid dosing
Definition
16 grams
Term
that is the risk of decrease TG
Definition
increase LDL
Term
tricor is 
Definition
fenofibrate
Term
trilipix is 
Definition
fenofibrate
Term
what is the only fibrate that has indication for use with statin
Definition
trilipix
Term
fibrate may increase what two common drug
Definition

warfarin

sulfonylurea

Term
Niacin contraindication
Definition

active liver disease

active PUD

arterial bleeding

Term
max dose for extended release niacin
Definition
2 grams
Term
slo niacin
Definition

otc

hetapotoxicity 

Term

niaspan tablets 

is it interchangable with other formulation

Definition
no
Term
what strength aspirin to premedicate niacin
Definition
325
Term
what is the max does for lovaza
Definition
4 capsule
Term
formulation for Heparin (UFH)
Definition

IV

Sq

Term
dosing UFH using what type of body weight
Definition
actual body weight
Term
UFH dose in prevention of VTE
Definition
5,000 u Q8 SC
Term

UFH 

Tx dose of VTE

Definition

80mg/kg bolus

then 18 units/kg/hr infusion

Term

percent drop in platelete to be considered as 

thrombocytopenia

Definition
50%
Term
antidote for herparin overdose
Definition

protamine 1 mg

 

will reverse 100 units

 

max 50 mg

Term
long term use of heparin may cause what side effects
Definition

hyperkalemia

thrombocytopenia

osteoporosis

Term
how to monitor heparin
Definition

aptt

 

at 6 hours post dose and every six hours untill range is 1.5-2.5 the controlled is reach

Term
what is used to monitor LMWH
Definition
anti Xa
Term
prophylaxis dose for lovenox
Definition

30 mg sc q 12

 

40 mg qd

 

crcl <30ml/min use 30mg SC QD

Term
lovenox tx dose
Definition

1mg/kg sc q12h

1.5mg/kg SC qd

 

crcl< 30ml/min use 1mg/k Sc qd

Term
lovenox how often to check cbc perameter
Definition
2-3 days
Term
which lmwh have sulfite allergy
Definition
tinzaparin
Term
arixtra is contraindicated in 
Definition
crcl< 30mg/ml
Term
how to switch warfarin to pradaxa
Definition

d/c warfarin and start when INR <2.0

 

Term
side effect of pradaxa
Definition
gastritis like syndrome
Term
high vitamin K food
Definition

broccoli

brussels sprouts

cabbage

canola oil

cauliflower

chickpea

cole slaw 

collard greens

coriander

endive

green kale

lettuce

mustart greens

parsley

soybean oil

spinach

Tea

Turnips greens

 

Term
INR < 5, supratherapeutic 
Definition
lower or omitt dose and resume
Term
INR between 5 and 9
Definition

omit 1-2 dose then resume 

or

omit one dose, give 1-2.5 vit K

Term
INR >9
Definition
hold warfarin, then give 2.5
Term
if patient is serious bleed and elevated INR
Definition

10mg K by slow IV with FFP

repeat q12

Term
life threatening with elevated INR
Definition

hold warfarin

give FFP,prothrombin complex

or 

recombinant factor VII with Vit K 10mg IV

Term
stop warfarin how many days prior to surgery
Definition
5
Term

DC 

lovenox

UFH 

prior to surgery

Definition

lovenox: 24 hours

UFH 4 hours

Term

resume LMWH

minor surgery

major surgary

Definition

minor resume 24 hours

major 48-72 hours

Term

asa and plavix 

stop when prior to surgery

Definition
5-10 days
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