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Flashcards in Bleeding and other things Deck (6)
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1
Q

What are the Xa inhibitors boxed warning?

How to convert between anticoagulants? READ

What to know about Dabigatran?

A

Neuraxial anesthesia are at risk of hematomas and subsequent paralysis. Edoxaban has reduced efficacy in Afib with CrCl >95. 5 mg BID for Eliquis unless over 80, younger than 60 or more than 1.5 SCr and it’s 2.5 BID. 10 mg BID 7 days then 5 bid for DVT/PE.Take Rivaroxaban with food.

Rivaroxaban is INR <3, Edoxaban <2.5, Apixaban and Dabigatran <2.

Unless it is within 6 hour skip dose. Start 5-10 days after parenteral anticoagulation. BBW of neuraxial anesthesia and CI’d in mechanical heart valves, Antidote is praxbind, watch for dyspepsia and gastritis like symptoms(bleeding). Discard 4 months after opening.

2
Q

When are Argatorban or Bivalrudin(Angiomax) used?

What to know about Warfarin?

What are the warfarin tablet colors?

A

Used in patients at risk for HIt. Safe for patients with HIT and no cross reaction with HIT antibodies. No antidote.

S enantiomer more potent in racemic mixture, 2,7,9,10 clotting factors. CI’d in pregnancy, watch for tissue necrosis/gangrene, HIT, presence of CYP2C9 or 3 alleles and/or polymorphism of VKORC1 gene. Bleeding, skin necrosis, purple toe syndrome. Goal INR is 2-3. Mechanical mitral valve is 2.5-3.5. Antidote is vitamin K.

Please let greg brown bring peaches to your wedding. Pink, lavender, green, brown, blue, peach, teal, yellow, white.

3
Q

How many mg of protamine will reverse 100 units of heparin?

Do you adminster kcentra with vitamin K?

What are warfarin reversal guidelines?

A
  1. reverse amount given in last 2-2.5 hours, max dose of 50 mg. 1 mg protamine per 1 mg enoxaparin.

Yes.

<4.5 without bleeding is skip dose and monitor INR. 4.5-10 without bleeding is hold 1-2 doses of warfarin. >10 without bleeding is oral vitamin K. Major bleeding is slow IV injection and PCC.

4
Q

Are vitamin B12 and folate macrocytic anemia?

What to know about iron?

What to know about Iron sucrose(venofer) and Ferumoxytol(Feraheme)?

A

YES. Iron is microcyctic.

325 mg PO to TID daily. Accidental overdose can lead to poisoning. Watch for constipation(dose-related), dark and tarry stools.

Anaphylactic reaction, must receive test dose of iron dextran. Triferic should be added to the bicarbonate concentrate of the hemodialysate.

5
Q

What to know about cyanocobalamin?

What to know about Epoetin alfa(epogen and procrit)?

What causes drug induced hemolytic anemia?

A

IM or deep SC, nasal solution is nascobal and one nostril once weekly.

Initiate when HbG <10 g/dL. 3x week, decrease or interrupt dose when exceeds 11 in CKD. Initiate when <10 in cancer. Increased risk of death, MI, stroke, VTE, thrombosis, tumor progression. Use lowest effective dose, watch for HgB .11, not indicated when outcome is cure. Hypertension, Monitor blood, IV route for hemo and store in fridge. Darbepoetin is for CKD and it’s weekly, 3 fold longer than epopoetin.

Beta-lactamase inhibitors, isonazid, cephalosporins, levodopa, methyldopa, penicillins, platinum-based chemo, quinidine, quinine, ribavirin, rifampin.

6
Q

What caused high risk hemolytic anemia with G6PD deficiency?

What are key vaccines in SCD?

What to know about Hydroxyurea?

A

Chloroquine, Dapsone, Methylene Blue, Nitrofurantoin, Primaquine, Probenecid, Rasburicase, Sulfonamides.

HIb, Penumococcal, Meningococcal.

stimulates production of HgbF. >3 moderate-severe pain crises in 1 year. BBW of myelosuppresion, embroy-fetal toxicity, avoid live vaccines, CBC with differential, Contraception required, Hazardous agent, Folic acid.

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