Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| test dose for Iron Dextran |
|
Definition
| 0.5 mL (25mg) over 30 seconds followed by monitoring for S/Sx anaphylaxis 1 hour |
|
|
Term
|
Definition
| 1000 mcg/day x 7-14 days then 100-1000 mcg/week till Hgb normalizes then 100-1000 mcg/month |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| CrCl 30-50 + concomitant use of dronedaron or systemic ketoconazole: consider 75 mg PO BID |
|
|
Term
| nephrotic syndrome and warfarin |
|
Definition
| increased warf clearance and decreased half-life |
|
|
Term
| hypermetabolic states and warfarin |
|
Definition
| increased anticoagulant effect of warf |
|
|
Term
| heart failure exacerbations and warfarin |
|
Definition
| increased anticoagulant effect of warf |
|
|
Term
| hepatic impairment and warfarin |
|
Definition
| increased baseline INR, NOT auto-anticoagulated--can go either way adjust accordingly |
|
|
Term
| rivaroxaban post-op DVT prophylaxis |
|
Definition
| 10 mg Q day with or without food |
|
|
Term
| rivaroxaban VTE treatment and secondary prophylaxis |
|
Definition
| 15 mg BID with food for 21 days then 20 mg Q day with food for remainder of treatment |
|
|
Term
| rivaroxaban non-valvular AFib with CrCl > 50 |
|
Definition
| 20 mg Q day with evening meal |
|
|
Term
| rivaroxaban non-valvular AFib with crcl 15-30 |
|
Definition
| 15 mg Q day with evening meal |
|
|
Term
| rivaroxaban and hepatic impairment |
|
Definition
| child-pugh class B/C associated with increased risk of coagulopathy |
|
|
Term
|
Definition
| CYP3A4 and P-glycoprotein inducers and inhibitors: avoid use |
|
|
Term
| Apixaban non-valvular AFib |
|
Definition
|
|
Term
| Apixaban post-op thromboprophylaxis in CANADA....so we don't freaking need to know this |
|
Definition
|
|
Term
| reduced dose apixaban in special populations (weight, age, Scr, on CYP3A4 and pglyco inhibitors) |
|
Definition
|
|
Term
| Heparin VTE prophylaxis SQ |
|
Definition
|
|
Term
| Heparin DVT/PE treatment IV |
|
Definition
| bolus: 80 U/kg *10,000 U max, initial infusion: 18 U/kg/h |
|
|
Term
| Acute myocardial infarction/ unstable Angina IV |
|
Definition
| bolus: 60-70 U/kg *5000 U max, infusion: 12-15 U/kg/h *1000 U/hr max |
|
|
Term
|
Definition
| 1mg/100U heparin *max single dose 50 mg in 10 min but may repeat, infuse slowly over 3-5 min |
|
|
Term
|
Definition
| 0.5-2 mcg/kg/min adjust with aPTT |
|
|
Term
| hepatic impairment dosing of argatroban for HIT |
|
Definition
|
|
Term
|
Definition
| 100 mcg/kg IV bolus followed by 1-3 mcg/kg/min |
|
|
Term
|
Definition
| see slides and table to memorize all these stupid doses that probably change from one institution to the next... |
|
|
Term
|
Definition
| contraindicated in patients with sever renal dysfunction (crcl<30) |
|
|
Term
| Fondaparinux acute MI STEMI |
|
Definition
| initial 2.5 mg IV then 2.5 mg Q day up to 8 days |
|
|
Term
| Fondaparinux acute MI NSTEMI |
|
Definition
| 2.5 mg SQ q day up to 8 days |
|
|
Term
|
Definition
| 5 mg-10 mg according to weight (less than 50kg-greater than 100kg) |
|
|
Term
|
Definition
| contraindicated <50 kg for VTE prophylaxis, treatment dose is reduced |
|
|
Term
| anti-Xa monitoring warranted for |
|
Definition
| renal insufficient patients on LMWH |
|
|
Term
|
Definition
| given IV as a single bolus 0.25 mg/kg, followed by an infusiong of 0.125 mcg/kg/min |
|
|
Term
| eptifibatide and tirofiban |
|
Definition
| require dose reductions for patients with renal insufficiency |
|
|
Term
|
Definition
| risk of thrombocytopenia higher than that of eptifibatide and even lower in abciximab |
|
|
Term
| fibrinolytic absolute contraindications |
|
Definition
| any prior intracranial hemorrhage,known cerebral vascular lesions, known malignant intracranial neoplasm, previous ischemic stroke within 3 months, suspected aortic dissection, active bleeding, significant closed head or facial trauma within 3 months |
|
|
Term
| absolute exclusion of r-tPA |
|
Definition
| head trauma or prior stroke in the last 3 months, hemorrhage, arterial puncture at non-compressible site in previous 7 days, elevated BP >185/110, acute bleeding diathesis, blood glucose<50, CT shows multilobar infarction |
|
|
Term
| alteplase in acute ischemic stroke |
|
Definition
| 0.9 mg/kg total dose(*max dosing of 90mg); 10% of total given as bolus of 1 minute and the rest over 1 hour infusion |
|
|
