Anticoagulation

DVT or PE

• Parentral (UFH) monitoring by aPTT (2-3 x higher than normal)
• UFH dose 5-10,000 units bolus, fol. by 1000 u/hr
• UFH advantage: short half life.
• UFH disadvantage: heparin induced thrombocytopenia.
• LMWH (enoxaparin), also Tinzaparin, Fondaparinux. Lab monitoring not required.
• dose adjustment for renal failure & obesity.
• Oral Warf, begin with 5mg (also available 1mg, 2mg). keep INR 2-3x, Avoid in Preg.
• Antidote: Protamine for Heparins; FFP for Warf, Vitamin K

Novel Anticoagulants (NOACs)

Now known as Direct oral anticoagulants (DOACs).

• Dabigatran (Pradaxa) - direct thrombin inhibitor
• Rivaroxaban(Xarelto) - factor Xa inhibitor
• Apixaban (Eliquis) - factor Xa inhibitor
• Edoxaban (Savaysa) - factor Xa inhibitor