Continuing Pharmacy Education / CE Master List / Perioperative Management of Warfarin Interruption
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Perioperative Management of Warfarin Interruption

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Review recommendations for when to interrupt warfarin therapy.
  2. Review guidelines for determining thromboembolic risk.
  3. Review recommendations for bridging therapy implementation.
  4. Review cases for appropriate method to manage warfarin interruption based on risk stratification.
  5. Apply case-specific monitoring parameters for anticoagulation bridge therapy.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Codes

ACPE #0009-0000-22-036-H01-P

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-036-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Victoria Lambert, Pharm.D., CACP
Clinical Coordinator
William W. Backus Hospital
Norwich, CT

Janki S. Shah, PharmD, BCACP
William W. Backus Hospital,
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Drs. Lambert and Shah have no relationships with any ineligible companies and therefore have nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Perioperative Management of Warfarin Interruption

 1. A patient presents to your clinic and informs you that he is having a colonoscopy.  He wants to know what to do with his warfarin for the procedure and seeks out your advice.

  1. Tell the patient to contact his PCP
  2. Review the patients indication for warfarin therapy and provide appropriate recommendations to PCP
  3. Stop warfarin for 5 days and bridge with LMWH
  4. Continue warfarin

 

2. Which is the correct description of CHADS2 scoring?

  1. CHF, hypertension, age >65, DM, prior history of stroke
  2. Cardiomyopathy, hypertension, age >75, DM, prior history of stroke
  3. CHF, hypertension, age > 75, DM, prior history of stroke
  4. CHF, hyperlipidemia, age >75, DM, prior history of stroke

 

3. TL is a 75 year old male on warfarin indefinitely for atrial fibrillation.  His CHADS2 score is 5. TL is scheduled for a biopsy of his bladder. Per coordination with his cardiologist, LMWH bridging is ordered and implemented according to your clinic protocol.  Three days after the procedure, he continues to have hematuria and the urologist advises to hold warfarin but continue LMWH due to his high CHADS2 score.  The urologist seeks your advice on the appropriate dose of LMWH.

  1. Continue full treatment dose and order antiXa levels
  2. Reduce the dose of LMWH to a prophylactic regimen until hematuria resolves, then resume warfarin and continue LMWH bridging until INR is therapeutic
  3. Stop LMWH and continue warfarin as it will take several days for warfarins fullest effects
  4. Defer to cardiology

 

4. Warfarin therapy must be interrupted for the following:

  1. Mole excision
  2. Hip Replacement surgery
  3. Cortisone injection in the knee
  4. Epidural
  5. B and D