Question | Answer |
Unfractionated Heparin | Standard of Care
Preventative 5000 U SC BID (moderate risk) or TID (High risk). Measure with aPTT(1.5-2.5 mean normal value) or ACT (for ACS) |
Enoxaparin (Lovenox) | LMWH, prevention dose 30 mg q 12h
treatment dose 1 mg/kg bid or 1.5 mg/kg QD
LMWH,safer than UFH, less chance of HIT, measure with Anti Xa activity if necessary, avoid in pt. with pork allergy |
Tinzaparin (Innohep) | Not approved for VTE prevention
175 U/kg SC QD |
Dalteparin (Fragmin) | prophylactic 2500-5000 U SC QD |
Fondaparinux (Arixtra) | Xa inhibitor, only for VTE, Won't cause HIT but can cause thrombocytopenia, preventative dose 2.5 mg, treatment dose 7.5 mg SC QD(for patients between 50-100 kg.)
Measure with Anti Xa activity |
Direct Thrombin Inhibitors (IV) | Bivalirudin (angiomax) for example
Expensive, and continuous IV infusion
Only used it pt. with HIT |
Rivaroxaban (Xarelto) | Oral Xa inhibitor. Stroke prophylaxis in Afib and DVT prophylaxis in knee/hip replacement
10 mg PO qd
10 mg PO |
Dabigatran (Pradaxa) | Oral Direct thrombin inhibitor, only for Stroke prophylaxis in Afib, quick onset/no overlap |
Warfarin (Coumidan) | Primary Oral Anticoagulant, Vitamin K antagonist, not immediate, steady state around 14 days, measure with PT or INR (2-3 or 2.5-3.5 in high risk), contraindicated in pregnancy, |
Protamine Sulfate | Antidote for UFH and LMWH |
Vitamin K | Antidote for Warfarin
INR 5-9 = 1-2.5 mg PO, >9(w/ no bleeding) = 2.5-5 mg PO, super serious!!=10 mg IV |
HCTZ (Hydrodiuril) | Thiazide diuretic, first line for uncomplicated HTN (12.5-50 mg QD, 25 is max effective), Don't use w/ low CrCl (<30) |
Furosemide (Lasix) | Loop diuretic, Daily dose 40-240 mg/ BID-TID, effective on pt. with kidney damage |
Triamterine (Dyrenium or Maxzide, which also contains HCTZ) | Potassium sparing Diuretic, 25-100 mg QD, decreases SCr, |
Spironolactone (Aldactone) | Aldosterone receptor blocker, K sparing, 25-50 mg QD-BID, Gynecomastia |
Aliskiren (Tekturna) | Renin inhibitor, 150-300 mg QD, angioedema, hyperkalemia (esp. in diabetes w/ ACE-I), contraindicated in pregnancy |
Reserpine (Serpasil) | peripheral adrenergic inhibitor, .05-.25 mg QD,
nasal congestion and sedation, rarely used |
Clonidine (Catapres) | Central Alpha(2) agonist, .2-1.2 mg BID-TID, rebound hypertension, bradycardia, impaired cognitive function in elderly |
Doxazosin (Cardura) | Alpha blocker, 1-16 mg QD (HS), hypotension and 1st dose syncope, also for BPH |
Atenolol (Tenormin) | Selective B1 blocker, 25-100 mg QD |
Propranolol (Inderal) | Non-selective Beta blocker, 40-480 mg BID, |
Carvedilol (Coreg) | Combined alpha/beta blocker, 12.5-50 mg BID, postural hypotension |
Minoxidil (Loniten) | Direct vasodilator, 5-100 mg QD, orthostatic hypotension, headaches, hirsuitism. |
Verapamil (Calan, Isoptin) | Non Dihydropyridine Ca channel blocker, 90-480 QD-BID, impaired cardiac conduction (Don't use w/ HF!!), constipation. |
Diltiazem (Tiazac,Cardizem) | Non Dihydropyridine Ca channel blocker 120-360 QD-BID, Impaired cardiac conduction (don't use w/ HF) |
Amlodipine (Norvasc) | Dihydropyridine Ca channel blocker, 2.5-10 mg QD, ankle edema, flushing, headache |
Lisinopril (Zestril, Prinivil) | ACE-I, 5-40 mg QD, cough, hyperkalemia, angioedema, Contraindicated in pregnancy |
Valsartan (Diovan) | Angiotensin II receptor blocker, 80-320 mg QD, same side effects as ACE-I except cough, contraindicated in pregnancy |