Pathophysiology/Risk Factors
The 3 parts of Virchow's Triad
What is:
Stasis
Endothelial Injury
Hypercoagulability
Prophylaxis option for patients at high bleeding risk
What is mechanical prophylaxis? (nonpharm)
Duration of provoked VTE treatment
What is 3 months?
DOACs that don't require overlap with a parenteral
What is:
Rivaroxaban
Apixaban
Most common side effect of anticoagulants
What is bleeding?
Oral contraception can increase risk in which of the 3 components of Virchow's Triad?
What is Hypercoagulability?
Best prophylaxis option for patients with poor renal function
What is subcutaneous Unfractionated Heparin?
Duration of therapy for an unprovoked VTE?
What is 3 months, may extend if the patient is at low/moderate bleeding risk
Neutralizes heparin in cases of bleeding
What is Protamine?
The overlap period in the warfarin/parenteral anticoagulant approach
What is:
an overlap of at least 5 days (and 2 therapeutic INRs)
Gold standard imaging for VTE
What is venography?
Pharmacologic prophylaxis CI in patients with a history of HIT (heparin-induced thrombocytopenia)
What is
heparin and LMWH?
Duration of therapy for a patient with a VTE and cancer
What is extended therapy unless in remission
A monoclonal antibody reversal agent with 350x affinity for dabigatran then thrombin, binding free and bound drug
What is Praxbind?
Examples: NSAID therapy, cancer, age >65, previous stroke, diabetes, antiplatelet therapy, recent surgery
What are risk factors for bleeding?
A Caprini risk factor of 4.
What is Moderate risk?
Prophylaxis option in patients with HIT
What is fondaparinux?
#1 therapy in acute anticoagulation approach
What is a DOAC ?
Reversal agent approved for reversal of warfarin in life threatening bleeds or need for urgent surgery, dosing based on INR
What is Kcentra?
When medications should be started in the case of unprovoked VTE
A good test to rule out thrombosis, not rule it in. (sensitive, not specific)
What is D-Dimer?
CI to pharmacologic prophylaxis?
What is active bleeding and platelet count of <1000 and a history of HIT (heparin and LMWH)
#2 therapy in acute anticoagulation approach
What is warfarin overlap with parenteral anticoagulant?
Medication approved for rivaroxaban and apixaban reversal only
What is Andexxa?
How often to monitor INR in warfarin upon initiation.
What is weekly INRs until stable, then every 4 weeks up to 12 weeks?