Term
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Definition
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Term
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Definition
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Term
test dose for Iron Dextran |
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Definition
0.5 mL (25mg) over 30 seconds followed by monitoring for S/Sx anaphylaxis 1 hour |
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Term
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Definition
1000 mcg/day x 7-14 days then 100-1000 mcg/week till Hgb normalizes then 100-1000 mcg/month |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
CrCl 30-50 + concomitant use of dronedaron or systemic ketoconazole: consider 75 mg PO BID |
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Term
nephrotic syndrome and warfarin |
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Definition
increased warf clearance and decreased half-life |
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Term
hypermetabolic states and warfarin |
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Definition
increased anticoagulant effect of warf |
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Term
heart failure exacerbations and warfarin |
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Definition
increased anticoagulant effect of warf |
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Term
hepatic impairment and warfarin |
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Definition
increased baseline INR, NOT auto-anticoagulated--can go either way adjust accordingly |
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Term
rivaroxaban post-op DVT prophylaxis |
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Definition
10 mg Q day with or without food |
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Term
rivaroxaban VTE treatment and secondary prophylaxis |
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Definition
15 mg BID with food for 21 days then 20 mg Q day with food for remainder of treatment |
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Term
rivaroxaban non-valvular AFib with CrCl > 50 |
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Definition
20 mg Q day with evening meal |
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Term
rivaroxaban non-valvular AFib with crcl 15-30 |
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Definition
15 mg Q day with evening meal |
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Term
rivaroxaban and hepatic impairment |
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Definition
child-pugh class B/C associated with increased risk of coagulopathy |
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Term
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Definition
CYP3A4 and P-glycoprotein inducers and inhibitors: avoid use |
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Term
Apixaban non-valvular AFib |
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Definition
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Term
Apixaban post-op thromboprophylaxis in CANADA....so we don't freaking need to know this |
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Definition
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Term
reduced dose apixaban in special populations (weight, age, Scr, on CYP3A4 and pglyco inhibitors) |
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Definition
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Term
Heparin VTE prophylaxis SQ |
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Definition
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Term
Heparin DVT/PE treatment IV |
|
Definition
bolus: 80 U/kg *10,000 U max, initial infusion: 18 U/kg/h |
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Term
Acute myocardial infarction/ unstable Angina IV |
|
Definition
bolus: 60-70 U/kg *5000 U max, infusion: 12-15 U/kg/h *1000 U/hr max |
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Term
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Definition
1mg/100U heparin *max single dose 50 mg in 10 min but may repeat, infuse slowly over 3-5 min |
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Term
|
Definition
0.5-2 mcg/kg/min adjust with aPTT |
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Term
hepatic impairment dosing of argatroban for HIT |
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Definition
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Term
|
Definition
100 mcg/kg IV bolus followed by 1-3 mcg/kg/min |
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Term
|
Definition
see slides and table to memorize all these stupid doses that probably change from one institution to the next... |
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Term
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Definition
contraindicated in patients with sever renal dysfunction (crcl<30) |
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Term
Fondaparinux acute MI STEMI |
|
Definition
initial 2.5 mg IV then 2.5 mg Q day up to 8 days |
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Term
Fondaparinux acute MI NSTEMI |
|
Definition
2.5 mg SQ q day up to 8 days |
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Term
|
Definition
5 mg-10 mg according to weight (less than 50kg-greater than 100kg) |
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Term
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Definition
contraindicated <50 kg for VTE prophylaxis, treatment dose is reduced |
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Term
anti-Xa monitoring warranted for |
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Definition
renal insufficient patients on LMWH |
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Term
|
Definition
given IV as a single bolus 0.25 mg/kg, followed by an infusiong of 0.125 mcg/kg/min |
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Term
eptifibatide and tirofiban |
|
Definition
require dose reductions for patients with renal insufficiency |
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Term
|
Definition
risk of thrombocytopenia higher than that of eptifibatide and even lower in abciximab |
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Term
fibrinolytic absolute contraindications |
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Definition
any prior intracranial hemorrhage,known cerebral vascular lesions, known malignant intracranial neoplasm, previous ischemic stroke within 3 months, suspected aortic dissection, active bleeding, significant closed head or facial trauma within 3 months |
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Term
absolute exclusion of r-tPA |
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Definition
head trauma or prior stroke in the last 3 months, hemorrhage, arterial puncture at non-compressible site in previous 7 days, elevated BP >185/110, acute bleeding diathesis, blood glucose<50, CT shows multilobar infarction |
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Term
alteplase in acute ischemic stroke |
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Definition
0.9 mg/kg total dose(*max dosing of 90mg); 10% of total given as bolus of 1 minute and the rest over 1 hour infusion |
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