PINK
What is the target resting heart rate for rate controlling therapies?
Resting heart rate <100 to 110bpm
The goal INR for patients treated with warfarin is what?
2-3
For which 2 agents used for AF should patients be inpatient for initiation of therapy?
Dofetilide and sotalol
When managing symptoms of AF in a newly diagnosed patient with a history of CHF who is symptomatic, would the use of rhythm control or rate control agents be preferred?
Rhythm
What are the goals for VTE?
Preventing fatal PE, reducing short term morbidities associated with acute DVT or PE thrombus, preventing recurrent VTE, preventing long-term sequelae of VTE, minimizing bleeding risk while on anticoagulation, INR of 2-3 for warfarin
Vaughan-Williams classification of verapamil is what?
4
What are the two indications that warfarin would be preferred over a DOAC for stroke prevention in AF?
Moderate to severe mitral stenosis or mechanical heart valve
How long after someone undergoes catheter ablation should anticoagulation therapy be continued?
3 months
A 53 year old male on anticoagulation therapy due to AF diagnosis was fired from his job and is currently without insurance. He was being treated with dabigatran but will not be able to afford it until he finds insurance again. What lab would need to be checked to determine when he should start warfarin therapy prior to stopping dabigatran?
CrCl
What does CHA2DS2-VASc stand for & a score of ___ in men & ___ in women indicates anticoagulation is necessary?
Chronic heart failure (1 pt), Hypertension (1 pt), Age ≥75 (2 pts), Diabetes (1 pt), Thromboembolism (ischemic stoke/TIA/Peripheral or pulmonary embolism) (2 pts), Vascular disease (1 pt), Age 65-74, Female (1pt),
For males it is ≥2 and ≥3 in women that indicates anticoagulation
Name a long-term rate control agent used in AF that is appropriate for a patient with a dx of HFrEF?
Any Beta Blocker or Digoxin
RF a white female 68 years old and weighs 68 kg is admitted to the hospital for knee surgery today. She is getting current treatment for her lung cancer. She has past medical history of osteoarthritis, hypertension, heart failure, and depression. She is now getting VTE treatment, what treatment should RF get and for how long?
Any DOAC medication and for extend phase treatment
RF a white female 68 years old and weighs 68 kg is admitted to the hospital for knee surgery today. She is getting current treatment for her lung cancer. She has past medical history of osteoarthritis, hypertension, heart failure, and depression. What is RFs bleeding risk factors and what classification is RFs bleeding factors?
Age over 65, cancer, comorbidities, and recent surgery. Classification is high risk
RF a white female 68 years old and weighs 68 kg is admitted to the hospital for knee surgery today. She is getting current treatment for her lung cancer. She has past medical history of osteoarthritis, hypertension, heart failure, and depression. RF got prescribed Rivaroxaban for her VTE treatment what is the dose of the rivaroxaban RF should currently be given and how should RF be taking rivaroxaban.
Rivaroxaban 10 mg po daily with food
Tikosyn is dosed based on CrCl. At what CrCl threshold is the use of Tikosyn contraindicated?
CrCl <20 mL/min
You have been tasked with assessing the bleeding risk for a patient under your care in the hospital. Given the following information, what is the patient’s HASBLED score? 59 year old white male, hypertension, normal renal/liver function, no history of bleeding or stroke, doesn’t take warfarin or any antiplatelets, nor NSAIDS, and lives in a dry county so he abstains from alcohol.
1 point
MW has both AF & HFrEF looking for a long-term rate control agent. Which ones would be the best option?
Bisoprolol, Metoprolol Succinate, Nebivolol
RF a white female 68 years old and weighs 68 kg is admitted to the hospital for knee surgery today. She is getting current treatment for her lung cancer. She has past medical history of osteoarthritis, hypertension, heart failure, and depression. What is RFs Padua score and if they are indicated for VTE prophylaxis or not?
Active cancer +3, reduced mobility (knee surgery) +3, rheumatological disorder +1, heart failure +1 for a score of 8 which is indicated for VTE prophylaxis
Name any 2 of the criteria that would qualify a patient for the reduced dose (2.5 mg) of apixaban?
greater than or equal to 80 years of age, less than or equal to 60 kg BW, and greater than or equal to SCr of 1.5 mg/dL
On an ECG for someone with AF you would see no visible __ waves and an irregularly irregular ____ complex
P waves, QRS complex