Chapter 2 BNF (Bleeding Disorders) Flashcards
VTE risk factors?
Immobility obesity BMI >30 Malignant diseases 60+ years personal history HRT/COC Pregnancy
Bleeding risk factors?
Thrombocytopenia
stroke
liver failure, haemophilia, von williebrands
systolic hypertension
Different durations of VTE prophylaxis?
General surgery - 5-7 days
Major cancer surgery in abdomen or pelvis - 28 days
knee/ hip - extended
Treatment of VTE?
LMWH or Unfractionated in renal failure
atleast 5 days until INR is 2 for 24hours
start oral warfarin at the same time
What should be monitored in unfractionated heparin?
APTT
VTE in pregnancy?
LMWH
lower risk of osteoporosis and thrombocytopenia
When are unfractionated heparins preferred?
High risk of bleeding
renal impairment
as shorter duration
Heparin antidote?
Protamine
Heparin side effects?
Haemorrhage
hyperkalemia
osteoporosis
Thombocytopenia
Warfarin tablet colours?
0.5 white
1mg brown
3mg blue
5mg pink
warfarin onset of action?
48-72hours
Warfarin dose and monitoring?
dose: 5mg initially adjust to 3mg-9mg at same time each day
monitor INR every 3 months
Warfarin duration of treatment in different indications?
Isolated calf DVT - 6 weeks
provoked VTE - 3 months
Unprovoked (AF) - at least 3 months
Warfarin MHRAs?
Antivirals
Daktarin oral gel
Calciphylaxis
Warfarin in surgery?
stop 5 days before
give phytomenandione if INR above 1.5
emergency: delay 6 - 12 house if not give vit K and dried prothrombin complex
If high risk of VTE, bridge with LMWH and stop 24 hours before surgery
high risk of bleeding, start LMWH 48hours after surgery
