Term
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Definition
trauma, tumor, previous DVT/PE, heart valve dx/ replacement, surgery, fractures, catheters, MI, atherosclerosis |
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Term
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Definition
preggers, malignancy, thrombocytosis, estrogen therapy, myloproliferative disorder, protein C/S deficiency, anti-phospholipid antibody syndrome, antithrombin deficiency, factor V leiden |
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Term
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Definition
AFib, bed rest, immobilization/ paralysis, venous obstruction (tumor, obesidy, preggers), left ventricular dysfunction |
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Term
pulmonary embolism diagnostic tests |
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Definition
X-ray, V/Q scan, pulmonary angiogram, spiral computed tomography (CT), D-diamer test |
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Term
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Definition
high negative predictive value, used when low clinical probability of DVT or PE ssessed |
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Term
non-pharmacologic VTE prophylaxis |
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Definition
intermittent pneumatic compression, graduated compression stockings, leg elevation, lex exercise, early post-op ambulation |
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Term
frequent aPTT monitoring for heparin |
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Definition
6h after loading dose, 6h after any change in infusiong; once stable (2 consecutive aPTT target range) and therapeutic--check every 24 hours |
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Term
activated clotting time (ACT) |
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Definition
used with large doses of heparin exceeding plasma concentrations of >1 unit/mL |
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Term
other labs for heparin monitoring |
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Definition
ACT, antifactor Xa activity, plasma heparin concentrations |
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Term
plasma heparin concentrations |
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Definition
used to establish therapeutic aPTT's in institutions or in patients with unreliable aPTTs |
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Term
thrombocytopenia with heparin |
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Definition
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Term
heparin induced thrombocytopenia |
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Definition
5-14 days, re-exposure may result in earlier onset, decreased RBC's by 50% from baseline, very low platelet counts rare |
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Term
other causes of thrombocytopenia |
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Definition
sepsis, perioperative hemodilution, other drug-induced, non-immune mediated HAT |
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Term
direct thrombin inhibitors |
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Definition
argatroban, bivalirudin (Angiomax), lepirudin (Refludan), desirudin (Iprivask) |
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Term
ACCP recommends against VKA therapy in HIT patients |
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Definition
until after the platelent count has substantially recovered to at least 150,000 |
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Term
ACCP recommends that VKA therapy in HIT patients be started |
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Definition
only with low, maintenance doses rather than with high initial doses |
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Term
ACCP recommends that non-heparin anticoagulants should be |
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Definition
continued until the platelet counthas reached stable plateau (INR reached intended target range), and an overlap period has occured with VKA therapy |
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Term
ACCP recommends the use of Vit K (10mg po or 5-10 mg IV) |
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Definition
in patients receiving VKA therapy at the time of diagnosis of HIT |
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