A 81-year-old woman is admitted with left-sided weakness and dysphasia. CT head shows an acute right middle cerebral artery territory infarction. She ...

Question

A 81-year-old woman is admitted with left-sided weakness and dysphasia. CT head shows an acute right middle cerebral artery territory infarction. She has a background of well-controlled atrial fibrillation on Apixaban 5 mg BD. She was adherent to her medication. She has a BMI of 62 kg and eGFR of 55 mL/min/1.73m². What should be assessed regarding her Apixaban dosing?

Accepted Answer

Whether she was truly adherent, and her stroke risk factors need review for additional modifiable factors

Answer

Whether she was on the correct dose - she may need dose reduction based on age alone

Answer

Whether she needs to be switched to Warfarin as DOACs are inferior for stroke prevention

Answer

Whether she should have been on 2.5 mg BD given her weight and renal function

Answer

Whether Aspirin should be added to Apixaban

uk-dgm MCQ (SBA): Apixaban Dosing Criteria Assessment