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Indications for warfarin?
- Prevention and treatment of VTE
- Prevention of thromboembolism in pateints with heart valves
- Prevention of stroke in patients with previous MI
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Precautions of warfarin?
Protein C or protein S deficinency - increased risk of skin necrosis
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Adverse effects of warfarin?
bleeding
skin necrosis, hair loss, nausea, vomiting,
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Dose of warfarin?
maintainance dose??
Usually 5mg once daily then adjust
usually 1-10mg daily.
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Counselling for warfarin?
Always take the same brand of tablets
Avoid cranberry juice in excessive amounts
Tell your doctor if you develop a painful purple bruise-like rash
Maintain a consistent diet
Tell other medical professionals you are taking warfarin
Look out for unexplained burising, or bleeding, red or dark brown urine or dark coloured faeces
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Indications of dipyridamole?
Prevention of thromboembolism in patients with prosthetic heart valves (with warfarin)
Secondary prevention of ischaemic stroke and TIA, including combination with aspirin
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Precautions of using dipyradimole?
Treatment with other blood thinners
Aortic stenosis
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Adverse effects of dipyridamole?
headache, diarrhoea, nausea, vomiting, hot flushes, hypotension, tachycardia
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Dose of dipyridamole?
thromboembolism prevention?
secondary stroke prevention?
thromboembolism prevention - 300–600 mg daily in 3 or 4 doses.
Secondary prevention of stroke and TIA -Controlled release, oral 200 mg twice daily.
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Counselling for dipyridamole?
This medicine is absorbed best if taken on an empty stomach 1 hour before, or 2 hours after, meals.
If it upsets your stomach, it can be taken with food or milk.
Some people get a bad headache with this medicine, especially at the start of treatment; tell your doctor if this happens to you.
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Indications for enoxaparin?
Prevention of VTE in surgical patients and in medical patients bedridden due to acute illness
Treatment of venous thrombosis
Treatment of acute STEMI, non-STEMI and unstable angina
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Precautions of enoxaparin?
caution in renal impairment, reduce dose if crcl < 30mL/min
increased risk of bleeding
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Adverse effects of enoxaparin?
bleeding, bruising and pain at injection site
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Dose of enoxaparin?
for VTE treatment?
SC, 1 mg/kg twice daily for 5- 10 days
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Counselling for enoxaparin?
tell your doctor if you have any signs of bleeding or unexplained bruising
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Precautions of using clopidogrel??
Metabolised by cyp to active form. Avoid use with cypc19 inhibitors
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Adverse effects of clopidogrel?
Diarrhoea, bleeding
GI ulcer
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Dose of clopidogrel?
75mg daily for antiplatelet activity
ACS - 300mg loading dose then 75mg maintainance for upto 12 months
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Indications for prasugrel?
Prevention of atherothrombotic events (with aspirin) in acute coronary syndromes (including STEMI and non-STEMI) to be managed with PCI
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Precautions of prasugrel?
- History of stroke or TIA -- contraindicated
- asian
- Elderly -- high risk of bleeding
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Adverse effects of prasugrel?
bleeding, rash
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Dose of prasugrel *with asprin*
60mg then 10mg daily
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