6 Monitoring, Bleeding Precautions, and Reversal Free Online FlashCards

What test is used to monitor warfarin?

Warfarin is monitored and dose-adjusted using the INR.

How is therapeutic unfractionated heparin monitored?

Therapeutic unfractionated heparin is monitored with aPTT or heparin-calibrated anti-Xa, according to institutional protocol.

How are DOACs monitored for safety?

DOAC doses are not routinely adjusted using PT/INR or aPTT. Periodic clinical review, blood counts, renal-function assessment, and checks of dose, adherence, and interactions support safe use.

What does a platelet decline plus new thrombosis during heparin therapy suggest?

Suspect heparin-induced thrombocytopenia (HIT): a platelet decline during heparin exposure, especially with new thrombosis, is concerning even when the platelet count is low.

What is the priority response to suspected HIT?

Stop heparin promptly and urgently notify the responsible clinician for evaluation and an alternative anticoagulation plan; do not continue or increase heparin.

What precautions can reduce avoidable bleeding risk?

Use a soft-bristled toothbrush and electric razor, check before starting medicines or supplements, and tell health professionals about antithrombotic medicines before procedures.

What should someone taking apixaban do after hitting their head?

Seek urgent medical assessment and disclose the apixaban use and time of the last dose. A head injury can cause internal bleeding even when no symptoms or visible bleeding appear at first.

What is a standard reversal approach for major warfarin bleeding?

For life-threatening or major warfarin-associated bleeding, a standard approach is four-factor prothrombin complex concentrate (4F-PCC) with intravenous vitamin K. Plasma may be used if 4F-PCC is unavailable.

Which agent reverses unfractionated heparin?

Protamine reverses unfractionated heparin. Its reversal of low-molecular-weight heparin is incomplete.

Which specific agent reverses dabigatran?

Idarucizumab is the specific reversal agent for dabigatran.

What guides reversal of serious factor Xa inhibitor bleeding?

For serious factor Xa inhibitor bleeding, follow current institutional guidance; 4F-PCC may be considered. In the United States, Andexxa has not been commercially sold since December 22, 2025.

Do normal PT/INR and aPTT rule out apixaban activity?

Normal PT/INR and aPTT do not reliably exclude clinically relevant apixaban activity. A drug-calibrated anti-factor Xa assay can help assess levels when needed and available.