Anticoagulation in Special Populations (L27)

in pregnancy, _________ is the best option

LMWH (Enoxaparin)

in pregnancy we should AVOID all __________

DOACs

in pregnancy we should AVOID __________ (unless they have a MHV)

Warfarin

in pregnancy we should AVOID Warfarin, unless the patient has a _____________

Mechanical Heart Valve (prosthetic; MHV)

in pregnancy we should AVOID _________ in the 1st trimester, and it may be ok to start in the 2nd trimester if given at a low dose

Aspirin

in pregnancy LMWH given _______ daily is preferred

twice (BID)

in pregnancy LMWH given BID is preferred and we do not need to monitor _________ levels

anti-FXa

in pregnancy LMWH given BID is preferred

we can use ________ if mom has impaired renal function and we can use _________ if mom has a history of HIT

UFH, Fondaparinux

in pregnancy LMWH given BID is preferred

we can use UFH if mom has _______________ and we can use Fondaparinux if mom has a history of ________

renal dysfunction, HIT

in pregnancy, we need to be sure ________ and ________ are washed out for at least 24 hours before getting an epidural

UFH or LMWH

in pregnancy, we need to be sure LMWH and/or UFH are _____________ for at least 24 hours before getting an epidural

washed out

in pregnancy, we need to be sure LMWH and/or UFH are washed out for at least __________ before getting an epidural

24 hours

in pregnancy, we need to be sure LMWH and/or UFH are washed out for at least 24 hours before getting ______________

epidural

in breastfeeding ________, or __________, or _________ are preferred

LMWH, UFH, Warfarin

in breastfeeding we should AVOID all _________

DOACs (and probs avoid Aspirin too)

if a patient has to take OCPs, ___________-only ones pose the lowest VTE risk

progestin

if a patient taking OCPs, ___________-containing ones pose the highest VTE risk

estrogen

in patients with CKD __________ or ___________ are preferred

UFH or Warfarin (LMWH maybeee)

in patients with CKD we should AVOID __________ and ___________

DOACs (*except Apixaban*) and Fondaparinux

in patients with ___________ we should AVOID DOACs (*except Apixaban*) and Fondaparinux

CKD

in patients with CKD we should AVOID DOACs (*except ___________*) and Fondaparinux

Apixaban

in patients with CKD we should AVOID DOACs (especially ___________ since it is dialyzable) and Fondaparinux

Dabigatran

in patients with CKD we should AVOID DOACs, except for Apixaban

which of the other DOACs is dialyzable and definitely should NOT be used

Dabigatran (dont use Riva or Edox either tho)

if giving UFH to a patient with CKD we should be monitoring __________

aPTT (and K+!!)aPTT

if giving _______ to a patient with CKD we should be monitoring aPTT

UFH

if giving UFH to a patient with CKD we should be monitoring aPTT and __________

K (potassium) (d/t hyperkalemia risk)

giving __________ can cause hyperkalemia in patients and therefore K+ (potassium) should be monitored

UFH

giving UFH can cause __________ in patients and therefore _____ should be monitored

hyperkalemia, K+ (potassium)

we should AVOID Edoxaban in pts with a CrCl _________

>95 (kidneys are toooo good😛)

we should AVOID ___________ in pts with a CrCl >96

Edoxaban

in obese patients ________, and ________, and __________ have weight-based dosing

Heparin, LMWH, Fondaparinux

in obese patients which of the oral therapies can we use

Apixaban and Rivaroxaban (Warfarin maybe, it’s hard to monitor)

in obese patients we can use ___________ and __________ (oral) regardless of BMI or weight

Apixaban and Rivaroxaban

in obese patients we can use Apixaban or Rivaroxaban (oral) regardless of BMI or weight

if a patients BMI is _______ or their weight is _______kg we can also use Dabigatran or Edoxaban

<40, <120

in obese patients we can use Apixaban or Rivaroxaban (oral) regardless of BMI or weight

if a patients BMI is <40 or their weight is <120kgwe can also use __________ or ___________

Dabigatran or Edoxaban

in obese patients we can use any DOACs if a patients BMI is <40 or weight is <120kg

if a patients BMI is >40 or their weight is >120kg, however, we cannot use _________ or _________

Dabigatran or Edoxaban

in patients with cancer, _________ are first-line

DOACs (for VTE, but probs avoid Dabigatran)

in patients with cancer, DOACs are first-line

if the patient has GI lesions, ________ is also good and _________ is the preferred DOAC

LMWH (Dalteparin), Apixaban

in patients with cancer, DOACs are first-line

if the patient has __________, LMWH (Dalteparin) is also good and Apixaban is the preferred DOAC

GI lesions