QuestionSBA
QuestionChoice
No routine monitoring of factor V is required with apixaban use.
50417
d
Factor V
QuestionChoice
No routine monitoring is required with apixaban use. INR would be monitored in patients taking warfarin.
50415
b
INR
QuestionChoice
No routine monitoring of prothrombin concentration is required with apixaban use.
50418
e
Prothrombin
QuestionChoice
No routine monitoring is required with apixaban use. This is because direct oral anticoagulants have a predictable pharmacokinetic and pharmacodynamic response when given at a set dose, unlike warfarin for example which has a higher degree of unpredictability.
50414
a
No routine monitoring required
QuestionChoice
No routine monitoring is required with apixaban use. Factor Xa is the clotting protein that apixaban inhibits, it does not need to be monitored.
50416
c
Factor Xa
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3666
Patients taking apixaban (DOACs) require no routine monitoring of their clotting factors
Topic
74
Elderly Care
10137
Case Presentation:  A 64-year-old gentleman is discharged from hospital following a diagnosis of atrial fibrillation. 


**PMH** Hypertension, Type 2 diabetes mellitus, Atrial fibrillation

**DH** Ramipril 10mg PO OD, Metformin 500mg PO BD, Atenolol 50mg PO OD, Apixaban 5mg PO BD

Both the atenolol and apixaban are new prescriptions.

Question: What routine monitoring is required for his new apixaban prescription?
a