Prescription: Apixaban: PE

Casebank Prescription
1

Where you are
You are an FY2 inn medicine.

Who the patient is
Mrs. Maria Smith, aged 60, has been admitted to the hospital because of breathlessness.
She is diagnosed with pulmonary embolism.

Other information
She is diagnosed case of hypercholesterolemia.
She had a long-haul fight 10 years ago.
She was prescribed the following medications:

  • Apixaban for 6 months
  • Atorvastatin 20mg OD PO.
  • Aspirin 75mg OD PO.

eGFR - 87
D-Dimer - Increased

What you must do
Write down the prescription for the above medications.
Check dose and write down the apixaban.

Special Note
None

Shortcut:

  1. Regular: Apixaban 10mg PO BD 7 days
    Additional information: Change dose to 5mg BD for 6 months, after 7 days.
  2. Hold Aspirin (?-write or skip)

Explanation:
Treatment of PE:

  • Apixaban 10 mg BD for 7 days followed by 5 mg BD maintenance for 6 months.
  • If you are given a duration prescribe for that duration, If nothing is given , prescribe for 3 months.

Note: Hold Aspirin and Dalteparin, while on Apixaban due to drug interactions.

1 Like
2

Do we write Aspirin and Dalteparin and then put a zigzag to stop it or completely skip them and not include in the prescription?

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3

We also had similar confusion.