Anticoag dosing Flashcards

1
Q

What weight is used for UFH dosing?

A

Actual body weight

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2
Q

Dosing UFH for VTE prophylaxis?

A

SC 5,000 Units SCQ8-12

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3
Q

Dosing for treatment of VTE for UFH?

A

80 units per kg IV followed by 18 units/kg/hr

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4
Q

Dosing for treatment of ACS or STEMI UFH

A

60 units/kg IV bolus max 4,000 Units

then 12 units/kg/hour infusion

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5
Q

Tetsing therapeutic levels for UFH? when and what

A

aPTT or anti Xa

aPPT taken 6 hours after initiation

Take every 6 hours until therapeutic range of 1.5-2.5 x patients baseline

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6
Q

What is the CrCl cut off for lovenox for VTE prophylaxis and hat is the dose?

A

CrCl<30

30 mg SC daily

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7
Q

VTE prophylaxis dosing for lovenox?

A

30 mg SC q12h or 40 mg SC daily

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8
Q

Treatment of VTE and UA/NSTEMI for lovenox?

A
  1. 1 mg/kg q12h
  2. or 1.5 mg/kg SC daily only for inpatient VTE treatment
  3. CrCl<30 mL/min 1mg/kg SC daily
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9
Q

What wt is used for lovenox and UFH?

A

Actual body wt

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10
Q

Tx of STEMI with Lovenox? <75

A

30 mg IV bolus plus a 1 mg/kg dose

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11
Q

Stemi Lovenox treatmnet <75 and CrCl <30

A

Same as normal pt less then 75

30 mg IV bolus plus a 1 mg/kg SC dose

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12
Q

Lovenox STEMI tx pt >75

A

0.75 mg/kg Q12 no bolus

CrCl< 30 1 mg/kg SC daily no bolus

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13
Q

If a patient has a CrCl< 30 what is the change in dosing usually for lovenox?

A

Change from q12 to daily

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14
Q

Drugs that increase blood pressure 7

A, C, D, E, I, N, S

A
  1. Amphetamines
  2. Cocaine
  3. Decongestants
  4. ESA
  5. Immunosuppressants
  6. NSAIDs
  7. Systemmic steroids
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15
Q

COmbo ACE or ARB + Diuretics 4

A
  1. Zestoretic
  2. Hyzaar
  3. Divan
  4. Benicar
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16
Q

ACE or ARB + CCB 2

A

Lotrel: Benazipril+amlodipine

Exforge: Valsartan/Amlodipine

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17
Q

Direct renin inhibitor + Diuretic 1

A

Aliskeren/HCTZ Tekturna HCT

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18
Q

Alpha 2 agonist + Diuretic 1

A

Methyldopa/HCTZ

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19
Q

BB + Diuretic? 2

A

Tenoretic; Atenolol+Chlorthalidone Tenoretic

Bisoprolol/HCTZ: Ziac

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20
Q

K sparing + thiazide type 1

A

Triamteren/HCTZ Maxide Dyazide

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21
Q

WHen should pregnant patient be treated with HTN meds?

A

SBP>= 160

DBP>=105

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22
Q

What are the 3 preferred meds for Pregnant HTN?

A

Labetalol, nifedipine ER, methyldopa

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23
Q

Microzide

A

HCTZ

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24
Q

When are thiazides not effective?

A

CrCl<30

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25
Q

Only thiazide available in IV?

A

Chlorthalidone

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26
Q

7 SEs of Thiazides

A
  1. Hypo Everything, except for calcium and uric acid
  2. Hypokal
  3. Hypomag
  4. Hyponat
  5. Hypercal
  6. Increase LDL and TG
  7. Hyperglycemia
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27
Q

THiazides decrease the clearance of what drug?

A

Lithium increased toxicity

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28
Q

Most common SEs of non-DHPs

A
  1. Fluching
  2. Reflex tachycardia
  3. HA
  4. Peripheral edema
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29
Q

What CCB is the DOC in pregnancy?

A

ER nifedipine (Adalat and Procardia)

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30
Q

All CCBs both DHPs and Non- can cause what?

A

Gingival hyperplasia but more so with verapamil

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31
Q

Lotensin

A

Benazopril

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32
Q

Vasotex and Vasotec IV

A

Enalaprilat

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33
Q

Altace

A

Ramipril

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34
Q

MOA of ACE

A

Block conversion of Ang 1-Ang2

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35
Q

Boxed warning for ACEs

A

Fetal toxicity

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36
Q

Contraindications to ACEs

A

Hx of Angioedema

use within 36 hours of neprilysn inhibitor (Sacubirtil/Valsartan)

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37
Q

5 warnings of ACes

A
  1. Angioedema
  2. hyperkalemia
  3. hypotension
  4. renal impairment
  5. Bilateral renal arterialstenosis
38
Q

ARB MOA?

A

Block binding of Ang II to anf II type receptor ATI

39
Q

What combo is contraindicated in DM patietns?

A

Aliskeren in combo with ACE or ARB

40
Q

Avapro?

A

Irbesartan

41
Q

Cozaar

A

Losartan

42
Q

Olmesartan warning?

A

Sprue-like enteropathy

43
Q

All forms of carvedolol?

A

Should be taken with food

44
Q

Beta 1 selective BBs? 3

A

Atenolol

Esmolol

Metoprolols

45
Q

Tenormin

A

Atenolol

46
Q

Brevibloc

A

Esmolol

47
Q

Lopressor and Toprol?

A

Should be taken with or immidiately after meal

48
Q

Metoprolol Tartrate IV to PO

A

1:2.5

49
Q

Beta 1 selective AMEBBA

A

Atenolol, Metoprollol, Esemolol, Bisprolol, ACE butolol

50
Q

Catapress

A

Clonidine

51
Q

What is the DOC in pregnancy?

A

Methyldopa

52
Q

Catapress patch instructions?

A

Apply weekly

53
Q

Methyldopa can cause what?

A

DILE

54
Q

What BBs are teratogenic?

A

ACE, ARB, Aleskerin

55
Q

What does hydralazine do?

A

Causes vasodilation of the arteries

56
Q

Hydralazine formulations?

A

IV and PO

57
Q

Warning for Hydralazine?

A

DILE

58
Q

What two HTN meds can cause DILE?

A

MEthyldopa

Hydralazine

59
Q

All women of child bearing age should get what?

A

Folate 400 mcg/day

60
Q

What supplementation should prgnant women get?

A

Increase folate to 600 mcg/day

61
Q

Pregnant women age 19-50 should get what?

A

Calcium 1000 mg/day and 600 IU/day VitD

62
Q

Acne drugs that are teratogenic?

A

Isotretinoin, topical retinoids

including tazoteren

63
Q

ABx that are teratogenic 2

A

Quinolone and Tertracyclines

64
Q

Anticoags that are teratogenic?

A

Warfarin but special considerations

65
Q

Dyslipidemia, HTN, and HF drugs that are teratogenic? 2

A

Statins

any RAAS drugs

66
Q

Hormones that are teratogenic?

A

Pretty much all of them

67
Q

Migraine meds that are teratogenic? 2

A

Dihydroergotamine

Ergotamine

68
Q

Other teratogenic drugs 10

H,L,M,M,P,R,T,T,W,D

A
  1. Hydroxyurea
  2. Lithium
  3. Methotrexate
  4. Misoprostol
  5. Paroxetine
  6. Ribavirin
  7. Thalidomide
  8. Topiramate
  9. Wt loss drugs / valrpoic acid
  10. Divalproex
69
Q

HTN in preg 3 pref

A

Labetolol

Methyldopa

Nefidipine

70
Q

Vaginal fungal infection in preg?

A

Topical antifungals x 7 days

71
Q

Main drugs for UTI in preg 2

A

Cephalexin

Ampicillin

x 7 days

72
Q

What two drugs are last line in UTI in preg?

A

Nitro

Bactrim

73
Q

VTE in preg

A

LMWH is preferred over UFH

74
Q

Note about UTI in preg?

A

Must treat bacteruria even if asymptomatic with negative UI

75
Q

Hypothyroidsim DOC for preg?

A

Levo increse dose by 30-50%

76
Q

Anticoag drugs that are not recommeneded in pregnancy

A

Warfarin is teratogenic

oral factor Xas are not recommened

77
Q

If patient has hyperthyroidism and needs treatment like graves disease

A

Propylthiouracil is preferred if trying to concieve and in the 1st trimester

Can swithc to methamazole during preg

78
Q

Pain meds that should not be used in pregnancy?

A

Codein and Tramadol

79
Q

Babies that are breastfeeding or partial should get what?

A

400 IU of VIt D per day

80
Q

Breasfed babies require what else?

A

1mg/kg dailt of iron for 4-6 months

81
Q

Drugs that should not be used during breastfeeding? 6

A
  1. Amphetamines
  2. Ergotamines
  3. Lamotrigine
  4. Lithium
  5. Statins
  6. Metro should be avoided or pump and dump
82
Q

What can be used for motion sickness in preg?

A

Trial lifestyle changes if not

Vit B6 Pyridoxine +/-doxylamine firdt line

83
Q

Preg Cat A

A

Controlled studies in animals and women show no risk

84
Q

Preg Cat B

A

Animal studies show no risk but there are no controlled studies in women

85
Q

Preg Cat C

A

Animal Studies show harm to the fetus and there are no controlled studies available

or studies are not available give if benefit outweighs risk

86
Q

Preg Cat D

A

Positive evidence of fetal harm but beneift mght outweigh risk

87
Q

Pre cat X

A

DO not use in pregnancy

88
Q

Drugs to avoid in pediatrics Contraindicated 4

A
  1. Codeine < 12
  2. Tramadol < 12
  3. Promethazine <2
  4. Ceftriaxone in neonates 1-28 days
89
Q

Drugs to avoid in pediatrics not generally recd

A
  1. Quinolones
  2. Tetracycline <8
  3. OTC teething meds with benzocaine <2
  4. OTC cough and cold < 6
90
Q

Acetaminophen child dosing?

A

10-15 mg.kg q4-6, max 75 mg/kg/day

91
Q

Max ibuprofen dose in children?

A

5-10 mg/kg q6-8

max 40 mg/kg/day