Dabigatran dosing for VTE treatment - ANSWER - 150 mg BID after 5-10 days of
injectable
Rivaroxaban dosing for VTE treatment - ANSWER - 15 mg BID w/ food x 21 days
then 20 mg daily w/ food
after 6 months, may be reduced to 10 mg daily
Apixaban dosing for VTE treatment - ANSWER - 10 mg BID for 7 days then 5 mg BID
,after 6 months, may be reduced to 2.5 mg BID
When to use apixaban 2.5 mg BID? - ANSWER - 2/3 Criteria:
1. age 80 or older
2. weight 60 kg or less
3. SCr 1.5 or greater
When to dose reduce rivaroxaban and edoxaban for renal function? - ANSWER - CrCl
< 50
Rivaroxaban to 15 mg daily and edoxaban to 30 mg daily
When to dose reduce dabigatran for renal function? - ANSWER - CrCl < 30 to 74 mg
BID
Protamine is a reversal agent for: - ANSWER - Heparin
Off label: LMWH
Andexanet alfa is a reversal agent for: - ANSWER - Factor Xa inhibitors (apixaban &
rivaroxaban)
Idarucizumab (Praxbind) is the reversal agent for: - ANSWER - Dabigatran
INR goal for mechanical mitral valve - ANSWER - 2.5-3.5
Duration of treatment with aspirin for patients with bioprosthetic surgical aortic or
mitral valves - ANSWER - indefinitely
Duration of treatment with DAPT for patients with bare metal stent - ANSWER - at
least 1 month
, Duration of treatment with warfarin for patients with bioprosthetic surgical aortic or
mitral valves - ANSWER - at least 3 months
Duration of treatment with DAPT for patients with a drug-eluting stent - ANSWER -
at least 1 year
Risk factors for developing VTE - ANSWER - Age > or = 40
Surgery
Trauma
Hypercoagulable states
Central venous catheterization
Estrogen use or selective estrogen receptor modulators
Erythropoiesis-stimulating agents
Previous VTE
Cancer & treatments
Immobility or lower-extremity paresis
Various medical conditions/disease states
Smoking
Obesity
VTE treatment strategies - ANSWER - Bridging -- Injectable + warfarin w/ at least 5
days overlap or until INR > 2
Switching -- Injectable x 5 days then start edoxaban or dabigatran
Monotherapy -- apixaban or rivaroxaban at high dose then lower maintenance
Edoxaban dosing for VTE treatment - ANSWER - 60 mg daily after 5-10 days of
injectable
Duration of VTE treatment - ANSWER - 3 months
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