Term
|
Definition
| trauma, tumor, previous DVT/PE, heart valve dx/ replacement, surgery, fractures, catheters, MI, atherosclerosis |
|
|
Term
|
Definition
| preggers, malignancy, thrombocytosis, estrogen therapy, myloproliferative disorder, protein C/S deficiency, anti-phospholipid antibody syndrome, antithrombin deficiency, factor V leiden |
|
|
Term
|
Definition
| AFib, bed rest, immobilization/ paralysis, venous obstruction (tumor, obesidy, preggers), left ventricular dysfunction |
|
|
Term
| pulmonary embolism diagnostic tests |
|
Definition
| X-ray, V/Q scan, pulmonary angiogram, spiral computed tomography (CT), D-diamer test |
|
|
Term
|
Definition
| high negative predictive value, used when low clinical probability of DVT or PE ssessed |
|
|
Term
| non-pharmacologic VTE prophylaxis |
|
Definition
| intermittent pneumatic compression, graduated compression stockings, leg elevation, lex exercise, early post-op ambulation |
|
|
Term
| frequent aPTT monitoring for heparin |
|
Definition
| 6h after loading dose, 6h after any change in infusiong; once stable (2 consecutive aPTT target range) and therapeutic--check every 24 hours |
|
|
Term
| activated clotting time (ACT) |
|
Definition
| used with large doses of heparin exceeding plasma concentrations of >1 unit/mL |
|
|
Term
| other labs for heparin monitoring |
|
Definition
| ACT, antifactor Xa activity, plasma heparin concentrations |
|
|
Term
| plasma heparin concentrations |
|
Definition
| used to establish therapeutic aPTT's in institutions or in patients with unreliable aPTTs |
|
|
Term
| thrombocytopenia with heparin |
|
Definition
|
|
Term
| heparin induced thrombocytopenia |
|
Definition
| 5-14 days, re-exposure may result in earlier onset, decreased RBC's by 50% from baseline, very low platelet counts rare |
|
|
Term
| other causes of thrombocytopenia |
|
Definition
| sepsis, perioperative hemodilution, other drug-induced, non-immune mediated HAT |
|
|
Term
| direct thrombin inhibitors |
|
Definition
| argatroban, bivalirudin (Angiomax), lepirudin (Refludan), desirudin (Iprivask) |
|
|
Term
| ACCP recommends against VKA therapy in HIT patients |
|
Definition
| until after the platelent count has substantially recovered to at least 150,000 |
|
|
Term
| ACCP recommends that VKA therapy in HIT patients be started |
|
Definition
| only with low, maintenance doses rather than with high initial doses |
|
|
Term
| ACCP recommends that non-heparin anticoagulants should be |
|
Definition
| continued until the platelet counthas reached stable plateau (INR reached intended target range), and an overlap period has occured with VKA therapy |
|
|
Term
| ACCP recommends the use of Vit K (10mg po or 5-10 mg IV) |
|
Definition
| in patients receiving VKA therapy at the time of diagnosis of HIT |
|
|
