Blood Thinners. What, When, Why, How. Mary Wilkie, MS, RN, CCNS Clinical Nurse Specialist Rush University Medical Center

Size: px
Start display at page:

Download "Blood Thinners. What, When, Why, How. Mary Wilkie, MS, RN, CCNS Clinical Nurse Specialist Rush University Medical Center"

Transcription

1 Blood Thinners What, When, Why, How Mary Wilkie, MS, RN, CCNS Clinical Nurse Specialist Rush University Medical Center

2 Objectives Discuss specific defects and/or disease processes in ACHD that require blood thinners Review the most common blood thinners that are available today

3 What Are Blood Thinners? Medications that help prevent clots from forming in the blood

4 Most Common Types of Blood Thinners Anticoagulants Increase the time it takes for blood to form a clot Antiplatelets Prevent platelets from sticking together and forming a clot Heparin Dalteparin (Fragmin) Enoxaparin (Lovenox) Warfarin (Coumadin or Jantoven) Dabigatran (Pradaxa) Rivaroxaban (Xarelto) Apixaban (Eliquis) Aspirin Clopidogrel (Plavix)

5 Terms to Know Thrombus - clot Thrombosus - formation of blood clots Thromboembolism - a clot (thrombus) that breaks loose and is carried by the bloodstream resulting in an obstruction of another vessel including the lungs, brain, kidneys, GI tract, leg

6 Clotting Bleeding

7 Blood Thinners in Adult Congenital Heart Disease Mechanical/bioprosthetic valve Atrial arrhythmias Fontan Circuit Transcatheter closure devices, stents, valves Cardiomyopathy/myocarditis Pulmonary Hypertension

8 Anticoagulation in the Fontan Circuit Early and late risk for thromboembolic event Increased risk factors: type of Fontan, enlarged atria, arrhythmias, decreased heart function, fenestration, PLE, liver congestion Evaluate individual risk factors Aspirin vs. Warfarin vs. combination INR goal 2-3 (varies by center) Single ventricle patients may be predisposed to both bleeding and clotting Risk factors may change over time! Important to do regular follow-up with echocardiogram

9 Prosthetic Valves Goal Mimic one s own native valve Mechanical Titanium, Teflon Very durable Require surgery Require life long anticoagulation Bioprosthetic Pigs heart valve or cows heart tissue Not as durable (most durable on the r side) Transcatheter bioprosthetic valves available Do not require lifelong anticoagulation Clotting Risk Higher in Mitral than Aortic valve position Risk increases with presence of atrial fibrillation, LV dysfunction, left atrial dilation, previous thromboembolism, other conditions that cause blood to clot

10 Anticoagulation for Prosthetic Heart Valves 2013 Prevention and Treatment of Thrombosis In Pediatric and Congenital Heart Disease: A Scientific Statement from the American Heart Association 2014 AHA/ACC Guidelines For The Management of Patients with Valvular Heart Disease

11

12 Right Heart Valve Replacement Bioprosthetic Pulmonary Valve - reasonable to forgo anticoagulation. Consider individual clotting risks Bioprosthetic Tricuspid Valve months of Warfarin with INR goal of lifelong low dose Aspirin. Again, consider individual risks Right sided mechanical valves Lack of data Warfarin Goal /- Aspirin Prevention and Treatment of Thrombosis In Pediatric and Congenital Heart Disease: A Scientific Statement from the American Heart Association. Circulation. 2013:128:

13 Anticoagulation Use for Atrial Arrhythmias Many ACH patients at risk for A-fib or A-flutter Fontan, TGA s/p Mustard or Senne procedure, s/p TOF, unrepaired ASD Important to evaluate individual s risk for clots Low risk patients - Aspirin High risk strongly consider Warfarin INR target range 2-3, except with a mechanical valve or recurrent thrombosis; then plus low dose ASA may be added May consider new anticoagulation agents in non-valvular a- fib

14 Thrombus Prevention Following Interventional Procedures Limited studies, mostly based on medical consensus ASD, VSD, PFO closure device, stents, percutaneous valves - Aspirin plus Clopidogrel (Plavix) for the first 6 months Consider Warfarin in patients with atrial arrhythmias (Afib), blood clotting disorder or previous stroke Nonsurgical Ablation procedure low dose Aspirin for 4-6 weeks following procedure

15 Use of Blood Thinners in Dilated Cardiomyopathy At risk for thrombus formation secondary to low cardiac output, decreased cardiac function, regional wall motion abnormalities, arrhythmias Limited recommendations as it relates to ACHD Ongoing therapy reasonable for those with arrhythmias, hx thrombosus/thromboembolism, SF 10% or EF < 25% Adult review suggests benefit in those with SF < 20%, LV dysfunction, hx of previous stroke, previous thrombus, arrhythmias Warfarin with/without Aspirin INR range 2-3

16 Anticoagulation in CHD Patients with Pulmonary Hypertension The use of anticoagulation may be reasonable in children and adults with pulmonary vascular obstruction disease associated with CHD Clinical judgment Requires further investigation

17 Special Circumstances to Consider Immobilization while traveling Obesity Oral contraceptives Pregnancy Other medical conditions e.g., Protein S or C abnormalities, chromosomal abnormalities

18 Warfarin Brand name Coumadin Decreases the body s ability to form clots by blocking Vitamin K dependent clotting factors

19 Warfarin Color Coded Tablets Convenient for titrating dose Possible safety risk

20 Warfarin Challenges Slow onset and offset of action Effect can be different person to person Narrow therapeutic index Many food and drug interactions

21 Contraindications to Warfarin Use Bleeding Pregnancy Allergy or intolerance to Warfarin Uncontrolled HTN* Liver disease* Recent surgery and procedures involving the nervous system, spine, eye* *Use with extreme caution

22 Complications of Warfarin Bleeding Warfarin Embryopathy 5-30% Osteoporosis 0.1 % Warfarin necrosis 0.02% Purple toe syndrome 0.01%

23 Signs of Bleeding Excessive bleeding of the gums or nose New /Significant Headaches Abdominal pain or cramping Vomiting blood or something that looks like coffee grounds Pink or brown colored urine Red or tarry black stool Heavier than usual menstrual flow Excessive bruising or bruises that get larger Cuts that won't stop bleeding after applying continuous pressure

24 Drug Interactions Increase Effect Antiarrhythmics Antibiotics Anticonvulsants Antidepressants Antifungals Antihyperlipidemics Anticoagulants Decrease Effect Antibiotics - Rifampin Antidepressants - SSRI, SNRI Antiepileptics - Phynetoin (Dilantin) - Phenobarbital - Carbamazepine (Tegretol) Always Notify Your Health Care Provider Before Starting or Stopping Medication

25 Warfarin is Affected by Foods that Contain Vitamin K Green, leafy vegetables including spinach, kale, lettuce, broccoli, cabbage, Brussels sprouts Avocado Soybean and Canola oil Mayonnaise and salad dressings Green tea Liver and organ meats Alcoholic beverages, cranberry and grapefruit juices all serve to increase the effect of Warfarin

26 Keep Your Diet Consistent!!

27

28

29 Activity While on Warfarin Keep exercise level regular Avoid contact sports and activities that could result in a serious blow to head, chest or abdomen and/or serious cuts or bleeding Wear a helmet when riding moving objects Caution with sharp objects

30 Considerations When Taking Warfarin Take medication at the some time each day Never take a pill to catch-up if you miss a dose Be aware of drug interactions including prescription meds, OTC meds, vitamins, herbal supplements, nutritional supplements Inform all healthcare providers that you have been prescribed Warfarin (includes dentist, chiropractor, alternative medicine doctor), especially when planning any procedure or surgery

31 Considerations When Taking Warfarin (con t.) Try to avoid medications that can cause bleeding: Aspirin, Ibuprofen, Aleve, Naproxen Read all med labels to be certain that they do not contain Aspirin Tylenol is usually OK, but check with MD first Make your doctor aware of any missed doses Generic vs. name brand Wear medical alert bracelet/tag

32 Renal Impairment in Warfarin Dose adjustments are generally not necessary Patients with renal impairment may have platelet defects causing increased risk of bleeding Use Caution!

33 Warfarin In Pregnancy/Breastfeeding Crosses the Placenta Animals and Human studies have demonstrated positive evidence of fetal abnormalities. Must carefully weigh risk/benefit American Academy of Pediatrics considers Warfarin as compatible with the practice of breast-feeding

34 INR Testing Guidelines INR (international normalized ratio) The INR is a standardized way to report the PT value which is the time in seconds that is needed for blood to clot The normal INR of a healthy person is 1 The higher the INR, the more risk you have of bleeding If INR is lower than the desired target, the more risk you have of clotting.

35 INR Testing Guidelines (con t.) Ideal target INR will vary depending on the medical condition and individual risk factors Most common INR range is 2-4 Common factors affecting INR - Drugs - Diet - Exercise - Alcohol use - Illness

36 Laboratory testing - Venous blood draw - Accurate INR Testing - Requires trip to clinic, hospital Point of Care(POC) Devices - Finger stick - Easy, accurate, convenient - Becoming more accepted by insurance companies

37 Low Molecular Weight Heparin (LMWH) Anticoagulant that inhibits the body s natural clotting factors Enoxaparin (Lovenox), Dalteparin (Fragmin) Inject SQ (under the skin) One or two time a day dosing No need for lab monitoring in most patients. May monitor anti X-a level. Good for long term and home use, safe during pregnancy, presumed safe with breastfeeding Often used as bridging medication Black box warning for spinal/epidermal hematomas Caution in renal and liver disease

38 Low Molecular Weight Heparin (LMWH) (con t.) Potential side effects: bleeding, nausea/vomiting Contraindications: active bleeding, low platelet count, hypersensitivity to heparin, pork, or benzyl alcohol Limited studies in use with mechanical valves Pregnant women may need closer monitoring and dose adjustment Timing of anti X-a - usually drawn 4 hours after administration of dose

39 Aspirin Antiplatelet Fewer bleeding complications that with Warfarin but may not prevent clotting in certain conditions 81 mg vs. 325 mg daily Doesn t require regular blood testing May need to be held 5-7 days before surgery or invasive procedure Common side effects: bleeding, heartburn, nausea, ulcer Caution in patients with history of GI bleed, renal or liver disease Use during pregnancy and during breastfeeding requires close monitoring

40 Clopidogrel (Plavix) Antiplatelet - affects platelet function and bleeding time for up to 7-10 days (recommend discontinuing 5 days prior to surgery) Usual dose 75 mg once a day Does not require regular blood testing Side effects: bleeding, TTP, rash, diarrhea Drug interactions: avoid concomitant use of PPI ( ex: Prilosec, Nexium), caution with SSRI, SNRI drugs Grapefruit /Plavix interaction?

41 Plavix Information on safety in pregnancy and breastfeeding has not been fully established Class B Pregnancy - animal data negative, no controlled human data Animal data did show excretion of drug into breast milk. No controlled human studies

42 Advantages of New Anticoagulants Rapid onset of action No need for bridging More predictable effect No need for routine coagulation monitoring Low potential for food/drug interactions No dietary restrictions

43 Dabigatran (Pradaxa) Use: Non-valvular Atrial Fibrillation No frequent blood testing needed Available in 75 mg and 150 mg capsules No antidote Side effects: Bleeding, GI upset,? increase risk for heart attack Less drug interactions - Caution with Rifampin, St. John s Wort, Tegretol, Phenytoin, Varapamil, Amiodarone, Zitromax, other drugs that cause bleeding No food-drug interactions

44 Dabigatran (Pradaxa) (con t.) Contraindications - Active bleeding - Renal impairment - Liver disease - Prosthetic heart valves - Valvular heart disease - Immunosupressants, Ketoconazole Unstable if not stored in original bottle or blister pack - NO pill boxes Must be used within 60 days while being stored in original bottle or blister pack Cost FDA statements

45 Rivaroxaban (Xarelto) Indication: Non-valvular Atrial Fibrillation, DVT, PE Not for use in prosthetic heart valves or mitral stenosis Once daily dosing - 20 mg No antidote Lab monitoring: Not needed. Drug interactions - Ketoconazole, Ritonavir, Clarithromycin, Erythromycin - Rifampicin Minimal food interactions-recommend to be taken with food No controlled studies in pregnant women

46 Apixaban (Eliquis) Indication: Nonvalvular Atrial Fibrillation, DVT No need for monitoring Recommend 5 mg twice daily dosing No established reversal/antidote Cut dose for kidney function, age > 80; wt < 60 kg Drug Interactions: Certain drugs may increase or decrease effect Ex: potency with Ketoconazole, Clarithromycin, potency with Rifampin, St. John s Wort, Phenytoin Not recommended for mechanical valves No adequate studies in pregnant women Hold at least 48 hours prior to high risk surgery/procedure and at least 24 hours before low risk procedure Bridging generally not requires Always Check with Your Healthcare Provider!

47 Become Educated Follow Directions Carefully Communicate

48 Thank You For Your Time!

What You Need to KnowWhen Taking Anticoagulation Medicine

What You Need to KnowWhen Taking Anticoagulation Medicine What You Need to KnowWhen Taking Anticoagulation Medicine What are anticoagulant medicines? Anticoagulant medicines are a group of medicines that inhibit blood clotting, helping to prevent blood clots.

More information

Sudden dizziness, trouble walking, loss of balance or coordination

Sudden dizziness, trouble walking, loss of balance or coordination rivaroxaban (Xarelto) Patient Education Information Sheet Veterans Health System Pharmacy Service 119 What is rivaroxaban (Xarelto)? A new anticoagulant ( blood thinner ) that reduces the risk of stroke

More information

Treatments for stroke prevention in Atrial Fibrillation as recommended by the Canadian Cardiovascular Society

Treatments for stroke prevention in Atrial Fibrillation as recommended by the Canadian Cardiovascular Society Treatments for stroke prevention in Atrial Fibrillation as recommended by the Canadian Cardiovascular Society Coumadin (Warfarin) Does this medication need ongoing monitoring of blood clotting times? Yes.

More information

Warfarin. (Coumadin, Jantoven ) Taking your medication safely

Warfarin. (Coumadin, Jantoven ) Taking your medication safely Warfarin (Coumadin, Jantoven ) Taking your medication safely Welcome This booklet is designed to provide you with important information about warfarin to help you take this medication safely and effectively.

More information

COMPARISON OF NEW ORAL ANTICOAGULANTS AND FREQUENTLY- ASKED QUESTIONS FROM PATIENTS. TARGET AUDIENCE: All Canadian health care professionals.

COMPARISON OF NEW ORAL ANTICOAGULANTS AND FREQUENTLY- ASKED QUESTIONS FROM PATIENTS. TARGET AUDIENCE: All Canadian health care professionals. COMPARISON OF NEW ORAL ANTICOAGULANTS AND FREQUENTLY- ASKED QUESTIONS FROM PATIENTS AND PHYSICIANS TARGET AUDIENCE: All Canadian health care professionals. OBJECTIVES: To provide a comparison of the new

More information

ACUTE STROKE UNIT ORIENTATION

ACUTE STROKE UNIT ORIENTATION ACUTE STROKE UNIT ORIENTATION 2014 TEACHING YOUR STROKE PATIENTS ABOUT THEIR MEDICATION Please refer to Module 8: Secondary Stroke Prevention for additional information Blood Pressure Medication Angiotensin

More information

FAQs about Warfarin (brand name Coumadin )

FAQs about Warfarin (brand name Coumadin ) FAQs about Warfarin (brand name Coumadin ) What is warfarin? Warfarin is the most commonly used anticoagulant in the US. An anticoagulant is a drug used to prevent unwanted and harmful blood clots. Although

More information

Living with a Non-Vitamin K Antagonist Oral Anticoagulant (NOAC)

Living with a Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) Living with a Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) dabigatran (Pradaxa ) rivaroxaban (Xarelto ) apixaban (Eliquis ) Information for patients Produced and made available by the Western Australian

More information

Treatment with Rivaroxaban

Treatment with Rivaroxaban UW MEDICINE PATIENT EDUCATION Treatment with Rivaroxaban Xarelto This handout explains the medicine rivaroxaban, a drug that helps prevent blood clots. What is rivaroxaban? Rivaroxaban (brand name Xarelto)

More information

Prevent Bleeding When Taking Blood Thinners

Prevent Bleeding When Taking Blood Thinners PATIENT EDUCATION patienteducation.osumc.edu Prevent Bleeding When Taking Blood Thinners Blood thinners are medicines used to keep harmful blood clots from forming in the body. Blood thinners can also

More information

Traditional anticoagulants

Traditional anticoagulants TEGH Family Practice Clinic Day April 4, 03 Use of Anticoagulants in 03: What s New (and What Isn t) Bill Geerts, MD, FRCPC Director, Thromboembolism Program, Sunnybrook HSC Professor of Medicine, University

More information

DVT/PE Management with Rivaroxaban (Xarelto)

DVT/PE Management with Rivaroxaban (Xarelto) DVT/PE Management with Rivaroxaban (Xarelto) Rivaroxaban is FDA approved for the acute treatment of DVT and PE and reduction in risk of recurrence of DVT and PE. FDA approved indications: Non valvular

More information

MEDICATION GUIDE COUMADIN (COU-ma-din) (warfarin sodium)

MEDICATION GUIDE COUMADIN (COU-ma-din) (warfarin sodium) MEDICATION GUIDE COUMADIN (COU-ma-din) (warfarin sodium) Read this Medication Guide before you start taking COUMADIN (warfarin sodium) and each time you get a refill. There may be new information. This

More information

Living with a New Oral Anticoagulant (NOAC)

Living with a New Oral Anticoagulant (NOAC) Living with a New Oral Anticoagulant (NOAC) dabigatran (Pradaxa ) rivaroxaban (Xarelto ) apixaban (Eliquis ) Information for patients Produced and made available by the Western Australian Medication Safety

More information

MEDICATION GUIDE XARELTO (zah-rel-toe) (rivaroxaban) Tablets

MEDICATION GUIDE XARELTO (zah-rel-toe) (rivaroxaban) Tablets MEDICATION GUIDE XARELTO (zah-rel-toe) (rivaroxaban) Tablets Read this Medication Guide before you start taking XARELTO and each time you get a refill. There may be new information. This Medication Guide

More information

Warfarin therapy for stroke patients with atrial fibrillation

Warfarin therapy for stroke patients with atrial fibrillation Warfarin therapy for stroke patients with atrial fibrillation Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm

More information

Medicines for stroke prevention in atrial fibrillation. Choosing the right one for you

Medicines for stroke prevention in atrial fibrillation. Choosing the right one for you Medicines for stroke prevention in atrial fibrillation Choosing the right one for you Atrial fibrillation (AF) is a condition that affects the heart, causing it to beat irregularly and too fast. When this

More information

Blood-thinning medication after stroke

Blood-thinning medication after stroke Stroke Helpline: 0303 3033 100 Website: stroke.org.uk Blood-thinning medication after stroke Blood-thinning medicines are drugs that help to prevent clots forming in your blood. They are often prescribed

More information

Brand Name Marevan Pradaxa Xarelto Eliquis

Brand Name Marevan Pradaxa Xarelto Eliquis Medicines for stroke prevention in atrial fibrillation Choosing the right one for you Atrial fibrillation (AF) is a condition that affects the heart, causing it to beat irregularly and too fast. When this

More information

Through Thick and Thin

Through Thick and Thin Through Thick and Thin Learning to Live with Warfarin South Denver Cardiology Associates PC What is Anticoagulation? Anti = against Coagulation = blood clotting An anticoagulant is a medication that reduces

More information

MEDICATION GUIDE ELIQUIS (ELL eh kwiss) (apixaban) tablets

MEDICATION GUIDE ELIQUIS (ELL eh kwiss) (apixaban) tablets MEDICATION GUIDE ELIQUIS (ELL eh kwiss) (apixaban) tablets What is the most important information I should know about ELIQUIS? For people taking ELIQUIS for atrial fibrillation: People with atrial fibrillation

More information

Treatment with Apixaban

Treatment with Apixaban UW MEDICINE PATIENT EDUCATION Treatment with Apixaban Eliquis This handout explains the medicine apixaban, a drug that helps prevent blood clots. What is apixaban? Apixaban (brand name Eliquis) is an anticoagulant

More information

Anticoagulants. Anticoagulants Definition. When are blood clots GOOD? Where and why do blood clots occur? 6/12/2014

Anticoagulants. Anticoagulants Definition. When are blood clots GOOD? Where and why do blood clots occur? 6/12/2014 Anticoagulants Steven R. Kayser, PharmD Professor Emeritus Department of Clinical Pharmacy UCSF Anticoagulants Definition A substance that hinders the clotting of blood Sometimes referred to as blood thinners

More information

Anticoagulation Therapy Update

Anticoagulation Therapy Update Anticoagulation Therapy Update JUDY R. WALLING, FNP-BC ARRHYTHMIA MANAGEMENT MUSC CARDIOLOGY Outline Who do we anticoagulate? Review classes of Anticoagulants Review examples of Anticoagulants Review CHADS2

More information

A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation

A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation PATIENT EDUCATION GUIDE What is atrial fibrillation? Atrial fibrillation

More information

News Release. Media Contacts: Kristina Chang Tel: (908) 927-2416 Mobile: (201) 213-4115 kchang12@its.jnj.com

News Release. Media Contacts: Kristina Chang Tel: (908) 927-2416 Mobile: (201) 213-4115 kchang12@its.jnj.com News Release Media Contacts: Kristina Chang Tel: (908) 927-2416 Mobile: (201) 213-4115 kchang12@its.jnj.com Christina Chan Tel: (908) 927-5769 Mobile: (908) 635-2406 cchan20@its.jnj.com Investor Relations

More information

New Oral Anticoagulants. How safe are they outside the trials?

New Oral Anticoagulants. How safe are they outside the trials? New Oral Anticoagulants How safe are they outside the trials? Objectives The need for anticoagulant therapy Indications for anticoagulation Traditional anticoagulant therapies Properties of new oral anticoagulants

More information

Anticoagulants for stroke prevention in atrial fibrillation Patient frequently asked questions

Anticoagulants for stroke prevention in atrial fibrillation Patient frequently asked questions Anticoagulants for stroke prevention in atrial fibrillation Patient frequently asked questions What is atrial fibrillation?...2 What are dabigatran, rivaroxaban and apixaban and what are they used for?...2

More information

Antiplatelet and Antithrombotic Therapy. Dr Curry Grant Stroke Prevention Clinic Quinte Health Care

Antiplatelet and Antithrombotic Therapy. Dr Curry Grant Stroke Prevention Clinic Quinte Health Care Antiplatelet and Antithrombotic Therapy Dr Curry Grant Stroke Prevention Clinic Quinte Health Care Disclosure of Potential for Conflict of Interest Dr. F.C. Grant Atrial Fibrillation FINANCIAL DISCLOSURE:

More information

Introduction to Atrial Fibrillation (AFib)

Introduction to Atrial Fibrillation (AFib) Introduction to Atrial Fibrillation (AFib) Learn About: 1. What is atrial fibrillation? 2. How will I feel? 3. Who gets AFib? 4. Risk of stroke 5. AFib treatment 6. How to live well with AFib 1. What is

More information

A PATIENT S GUIDE TO DEEP VEIN THROMBOSIS TREATMENT

A PATIENT S GUIDE TO DEEP VEIN THROMBOSIS TREATMENT A PATIENT S GUIDE TO DEEP VEIN THROMBOSIS TREATMENT This medicine is subject to additional monitoring. This will allow quick identification of new safety information. If you get any side effects, talk

More information

TSOAC Initiation Checklist

TSOAC Initiation Checklist Task Establish appropriate dose based on anticoagulant selected, indication and patient factors such as renal function. Evaluate for medication interactions that may necessitate TSOAC dose adjustment.

More information

Your Guide to Coumadin / Warfarin Therapy

Your Guide to Coumadin / Warfarin Therapy Your Guide to Coumadin / Warfarin Therapy 5 Things You MUST Know About Coumadin (Generic Name Warfarin) 1. You must have your blood checked regularly to prevent clots and bleeding. 2. Many medicines interact

More information

what is warfarin? Treatment with Warfarin (Coumadin ) What is warfarin?

what is warfarin? Treatment with Warfarin (Coumadin ) What is warfarin? What is warfarin? Warfarin sodium (Coumadin ) is a medication that works as an anti-coagulant. Anti means against and coagulant refers to blood clotting. An anticoagulant helps to prevent clots from forming

More information

Rivaroxaban (Xarelto) for preventing stroke

Rivaroxaban (Xarelto) for preventing stroke Rivaroxaban (Xarelto) for preventing stroke in people with atrial fibrillation This Medicine Update is for people with atrial fibrillation who are taking, or thinking about taking, rivaroxaban. Summary

More information

Analyzing Clinical Trial Findings of the Efficacy and Safety Profiles of Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation

Analyzing Clinical Trial Findings of the Efficacy and Safety Profiles of Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Analyzing Clinical Trial Findings of the Efficacy and Safety Profiles of Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Drew Baldwin, MD Virginia Mason Seattle, Washington NCVH May 29,

More information

Guide to Dabigatran, Rivaroxaban and Apixaban

Guide to Dabigatran, Rivaroxaban and Apixaban Page 1 of 8 Guide to Dabigatran, Rivaroxaban and Apixaban Medicines to Prevent Blood Clots If you are deaf or hard of hearing, please let us know. We provide many free services including sign language

More information

What Does Pregnancy Have to Do With Blood Clots in a Woman s Legs?

What Does Pregnancy Have to Do With Blood Clots in a Woman s Legs? Patient s Guide to Prevention of Blood Clots During Pregnancy: Use of Blood-Thinning A Patient s Guide to Prevention of Blood Clots During Pregnancy: Use of Blood-Thinning Drugs to Prevent Abnormal Blood

More information

Preventing Blood Clots After Hip or Knee Replacement Surgery or Surgery for a Broken Hip. A Review of the Research for Adults

Preventing Blood Clots After Hip or Knee Replacement Surgery or Surgery for a Broken Hip. A Review of the Research for Adults Preventing Blood Clots After Hip or Knee Replacement Surgery or Surgery for a Broken Hip A Review of the Research for Adults Is This Information Right for Me? Yes, if: You are considering or planning to

More information

Medication Guide Plavix (PLAV-iks) (clopidogrel bisulfate) tablets

Medication Guide Plavix (PLAV-iks) (clopidogrel bisulfate) tablets Medication Guide Plavix (PLAV-iks) (clopidogrel bisulfate) tablets Read this Medication Guide before you start taking Plavix and each time you get a refill. There may be new information. This Medication

More information

Shaun Mickus Phone: 908.927.2416 Mobile: 973.476.7144 smickus@its.jnj.c om

Shaun Mickus Phone: 908.927.2416 Mobile: 973.476.7144 smickus@its.jnj.c om News Release Media contacts: Ernie Knewitz Tel: 908.927.2953 Mobile: 917.697.2318 eknewitz@its.jnj.com Shaun Mickus Phone: 908.927.2416 Mobile: 973.476.7144 smickus@its.jnj.c om Investor contacts: Stan

More information

FDA Approved Oral Anticoagulants

FDA Approved Oral Anticoagulants FDA Approved Oral Anticoagulants Generic (Trade Name) Warfarin (Coumadin, Jantoven ) 1 FDA approved indication Prophylaxis and treatment of venous thromboembolism (VTE) Prophylaxis and treatment of thromboembolic

More information

Introduction. Background to this event. Raising awareness 09/11/2015

Introduction. Background to this event. Raising awareness 09/11/2015 Introduction Primary Care Medicines Governance HSCB Background to this event New class of medicines Availability of training Increasing volume of prescriptions Reports of medication incidents Raising awareness

More information

Atrial Fibrillation and Anticoagulants

Atrial Fibrillation and Anticoagulants York Teaching Hospital NHS Foundation Trust Atrial Fibrillation and Anticoagulants A guide to your diagnosis and treatment Information for patients, relatives and carers For more information, please contact:

More information

Safety Information Card for Xarelto Patients

Safety Information Card for Xarelto Patients Safety Information Card for Xarelto Patients 15mg Simply Protecting More Patients 20mg Simply Protecting More Patients Keep this card with you at all times Present this card to every physician or dentist

More information

Planning: Patient Goals and Expected Outcomes The patient will: Remain free of unusual bleeding Maintain effective tissue perfusion Implementation

Planning: Patient Goals and Expected Outcomes The patient will: Remain free of unusual bleeding Maintain effective tissue perfusion Implementation Obtain complete heath history including allergies, drug history and possible drug Assess baseline coagulation studies and CBC Assess for history of bleeding disorders, GI bleeding, cerebral bleed, recent

More information

Warfarin Counseling. Clinic Patient Education

Warfarin Counseling. Clinic Patient Education Warfarin Counseling Clinic Patient Education The UCSD Anticoagulation Clinic The UCSD Anticoagulation clinic is run by pharmacists The 2 clinic locations Hillcrest: 330 Lewis Street (@ 4 th Ave) La Jolla:

More information

XARELTO (Za-REL-toe) rivaroxaban

XARELTO (Za-REL-toe) rivaroxaban (Za-REL-toe) rivaroxaban Consumer Medicine Information WHAT IS IN THIS LEAFLET This leaflet answers some common questions about Xarelto. It does not contain all the available information. It does not take

More information

Daily aspirin therapy: Understand the benefits and risks

Daily aspirin therapy: Understand the benefits and risks Daily aspirin therapy: Understand the benefits and risks Is an aspirin a day the right thing for you? It's not as easy a decision as it sounds. Know the benefits and risks before considering daily aspirin

More information

ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR DEEP VEIN THROMBOSIS (DVT)

ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR DEEP VEIN THROMBOSIS (DVT) ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR DEEP VEIN THROMBOSIS (DVT) Information Leaflet Your Health. Our Priority. Page 2 of 6 What Are Anticoagulants And What Do They Do? This information leaflet

More information

Three new/novel oral anticoagulants (NOAC) have been licensed in Ireland since 2008:

Three new/novel oral anticoagulants (NOAC) have been licensed in Ireland since 2008: Key Points to consider when prescribing NOACs Introduction Three new/novel oral anticoagulants (NOAC) have been licensed in Ireland since 2008: Dabigatran Etexilate (Pradaxa ) 75mg, 110mg, 150mg. Rivaroxaban

More information

MCHENRY WESTERN LAKE COUNTY EMS SYSTEM OPTIONAL CE ADVANCED LEVEL (EMTP, PHRN, ECRN) August 2013. Anticoagulants

MCHENRY WESTERN LAKE COUNTY EMS SYSTEM OPTIONAL CE ADVANCED LEVEL (EMTP, PHRN, ECRN) August 2013. Anticoagulants MCHENRY WESTERN LAKE COUNTY EMS SYSTEM OPTIONAL CE ADVANCED LEVEL (EMTP, PHRN, ECRN) August 2013 Anticoagulants Anticoagulants are agents that prevent the formation of blood clots. Before we can talk about

More information

ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR ATRIAL FIBRILLATION

ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR ATRIAL FIBRILLATION ORAL ANTICOAGULANTS - RIVAROXABAN (XARELTO) FOR ATRIAL FIBRILLATION Information Leaflet Your Health. Our Priority. Page 2 of 6 What Are Anticoagulants And What Do They Do? This information leaflet has

More information

Novel oral anticoagulant (NOAC) for stroke prevention in atrial fibrillation Special situations

Novel oral anticoagulant (NOAC) for stroke prevention in atrial fibrillation Special situations Novel oral anticoagulant (NOAC) for stroke prevention in atrial fibrillation Special situations Dardo E. Ferrara MD Cardiac Electrophysiology North Cascade Cardiology PeaceHealth Medical Group Which anticoagulant

More information

Inpatient Anticoagulation Safety. To provide safe and effective anticoagulation therapy through a collaborative approach.

Inpatient Anticoagulation Safety. To provide safe and effective anticoagulation therapy through a collaborative approach. Inpatient Anticoagulation Safety Purpose: Policy: To provide safe and effective anticoagulation therapy through a collaborative approach. Upon the written order of a physician, Heparin, Low Molecular Weight

More information

The Role of the Newer Anticoagulants

The Role of the Newer Anticoagulants The Role of the Newer Anticoagulants WARFARIN = Coumadin DAGIBATRAN = Pradaxa RIVAROXABAN = Xarelto APIXABAN = Eliquis INDICATION DABIGATRAN (Pradaxa) RIVAROXABAN (Xarelto) APIXABAN (Eliquis) Stroke prevention

More information

3/25/14. To Clot or Not What s New In Anticoagulation? Clotting Cascade. Anticoagulant drug targets. Anita Ralstin, MS CNS CNP. Heparin.

3/25/14. To Clot or Not What s New In Anticoagulation? Clotting Cascade. Anticoagulant drug targets. Anita Ralstin, MS CNS CNP. Heparin. To Clot or Not What s New In Anticoagulation? Anita Ralstin, MS CNS CNP 1 Clotting Cascade 2 Anticoagulant drug targets Heparin XI VIII IX V X VII LMWH II Warfarin Fibrin clot 1 Who Needs Anticoagulation

More information

Anticoagulant therapy

Anticoagulant therapy Anticoagulation: The risks Anticoagulant therapy 1990 2002: 600 incidents reported 120 resulted in death of patient 92 deaths related to warfarin usage 28 reports related to heparin usage Incidents in

More information

STROKE PREVENTION IN ATRIAL FIBRILLATION

STROKE PREVENTION IN ATRIAL FIBRILLATION STROKE PREVENTION IN ATRIAL FIBRILLATION OBJECTIVE: To guide clinicians in the selection of antithrombotic therapy for the secondary prevention of ischemic stroke and arterial thromboembolism in patients

More information

Non- Valvular Atrial Fibrillation and Stroke Prevention: Which OAC Do I Choose. Warfarin vs the NOACs

Non- Valvular Atrial Fibrillation and Stroke Prevention: Which OAC Do I Choose. Warfarin vs the NOACs Non- Valvular Atrial Fibrillation and Stroke Prevention: Which OAC Do I Choose Warfarin vs the NOACs Dr. Lori McIntosh D.O. Board Certified Neurologist Objectives Be able to list the current options of

More information

XARELTO (Za REL toe) rivaroxaban

XARELTO (Za REL toe) rivaroxaban (Za REL toe) rivaroxaban Consumer Medicine Information WHAT IS IN THIS LEAFLET This leaflet answers some common questions about It does not contain all the available information. It does not take the place

More information

Anticoagulation: How Do I Pick From All the Choices? Jeffrey H. Neuhauser, DO, FACC BHHI Primary Care Symposium February 28, 2014

Anticoagulation: How Do I Pick From All the Choices? Jeffrey H. Neuhauser, DO, FACC BHHI Primary Care Symposium February 28, 2014 Anticoagulation: How Do I Pick From All the Choices? Jeffrey H. Neuhauser, DO, FACC BHHI Primary Care Symposium February 28, 2014 Atrial Fibrillation 2 Atrial Fibrillation The most common arrhythmia encountered

More information

RIVAROXABAN. Consumer Information

RIVAROXABAN. Consumer Information RIVAROXABAN Consumer Information Rivaroxaban is a medicine that is used to increase the time it takes for blood to clot. It belongs to a class of medicines called anticoagulants, which are sometimes also

More information

Anticoagulation at the end of life. Rhona Maclean Rhona.maclean@sth.nhs.uk

Anticoagulation at the end of life. Rhona Maclean Rhona.maclean@sth.nhs.uk Anticoagulation at the end of life Rhona Maclean Rhona.maclean@sth.nhs.uk Content Anticoagulant Therapies Indications for anticoagulation Venous thromboembolism (VTE) Atrial Fibrillation Mechnical Heart

More information

Rx Updates New Guidelines, New Medications What You Need to Know

Rx Updates New Guidelines, New Medications What You Need to Know Rx Updates New Guidelines, New Medications What You Need to Know Maria Pruchnicki, PharmD, BCPS, BCACP, CLS Associate Professor of Clinical Pharmacy OSU College of Pharmacy Background scope and impact

More information

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. A. Prescriptions That Require Prior Authorization

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. A. Prescriptions That Require Prior Authorization MEDICAL ASSISTANCE HBOOK I. Requirements for Prior Authorization of Anticoagulants A. Prescriptions That Require Prior Authorization Prescriptions for Anticoagulants which meet any of the following conditions

More information

A PATIENT S GUIDE TO PULMONARY EMBOLISM TREATMENT

A PATIENT S GUIDE TO PULMONARY EMBOLISM TREATMENT A PATIENT S GUIDE TO PULMONARY EMBOLISM TREATMENT This medicine is subject to additional monitoring. This will allow quick identification of new safety information. If you get any side effects, talk to

More information

Dorset Cardiac Centre

Dorset Cardiac Centre P a g e 1 Dorset Cardiac Centre Patients with Atrial Fibrillation/Flutter undergoing DC Cardioversion or Ablation procedures- Guidelines for Novel Oral Anti-coagulants (NOACS) licensed for this use February

More information

Update on Antiplatelets and anticoagulants. Outlines. Antiplatelets and Anticoagulants 1/23/2013. Timir Paul, MD, PhD

Update on Antiplatelets and anticoagulants. Outlines. Antiplatelets and Anticoagulants 1/23/2013. Timir Paul, MD, PhD Update on Antiplatelets and anticoagulants Timir Paul, MD, PhD Antiplatelets Indications Doses Long term use (beyond 12 months) ASA and combination use of NSAIDS ASA resistance Plavix resistance Plavix

More information

Atrial fibrillation: medicines to help reduce your risk of a stroke what are the options?

Atrial fibrillation: medicines to help reduce your risk of a stroke what are the options? Patient decision aid Atrial fibrillation: medicines to help reduce your risk of a stroke what are the options? http://guidance.nice.org.uk/cg180/patientdecisionaid/pdf/english Published: June 2014 About

More information

Anticoagulants in Atrial Fibrillation

Anticoagulants in Atrial Fibrillation Anticoagulants in Atrial Fibrillation Starting and Stopping Them Safely Carmine D Amico, D.O. Overview Learning objectives Introduction Basic concepts Treatment strategy & options Summary 1 Learning objectives

More information

UW MEDICINE PATIENT EDUCATION. Xofigo Therapy. For metastatic prostate cancer. What is Xofigo? How does it work?

UW MEDICINE PATIENT EDUCATION. Xofigo Therapy. For metastatic prostate cancer. What is Xofigo? How does it work? UW MEDICINE PATIENT EDUCATION Xofigo Therapy For metastatic prostate cancer This handout explains how the drug Xofigo is used to treat metastatic prostate cancer. What is Xofigo? Xofigo is a radioactive

More information

Program Objectives. Why Use Anticoagulants? 6/5/2014

Program Objectives. Why Use Anticoagulants? 6/5/2014 Larry Reis RPh CGP FASCP Prepared June 2014 for NADONA REIS RXCARE CONSULTING Reisrxcare@comcast.net 1 Program Objectives Discuss complications of current anticoagulant Rx Identify risks of using anticoagulants

More information

Dabigatran (Pradaxa) Guidelines

Dabigatran (Pradaxa) Guidelines Dabigatran (Pradaxa) Guidelines Dabigatran is a new anticoagulant for reducing the risk of stroke in patients with atrial fibrillation. Dabigatran is a direct thrombin inhibitor, similar to warfarin, without

More information

Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust.

Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust. Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust. This Patient Group Direction (PGD) has been written

More information

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. A. Prescriptions That Require Prior Authorization

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. A. Prescriptions That Require Prior Authorization MEDICAL ASSISTANCE HBOOK PRI AUTHIZATION OF PHARMACEUTICAL SERVICES I. Requirements for Prior Authorization of Anticoagulants A. Prescriptions That Require Prior Authorization Prescriptions for Anticoagulants

More information

UHS CLINICAL CARE COLLABORATION: Outpatient & Inpatient

UHS CLINICAL CARE COLLABORATION: Outpatient & Inpatient Guidelines for Anticoagulation Initiation and Management Y2014 UHS CLINICAL CARE COLLABORATION: Outpatient & Inpatient Topic Page Number MEDICATION FLOW AND PATIENT FLOW... 2 AND 3 PARENTERAL ANTICOAGULANTS...

More information

Prescriber Guide. 20mg. 15mg. Simply Protecting More Patients. Simply Protecting More Patients

Prescriber Guide. 20mg. 15mg. Simply Protecting More Patients. Simply Protecting More Patients Prescriber Guide 20mg Simply Protecting More Patients 15mg Simply Protecting More Patients 1 Dear Doctor, This prescriber guide was produced by Bayer Israel in cooperation with the Ministry of Health as

More information

Appendix C Factors to consider when choosing between anticoagulant options and FAQs

Appendix C Factors to consider when choosing between anticoagulant options and FAQs Appendix C Factors to consider when choosing between anticoagulant options and FAQs Choice of anticoagulant for non-valvular* atrial fibrillation: Clinical decision aid Patients should already be screened

More information

Real-World Data Confirms Safety and Efficacy Profile of XARELTO, With Shorter Hospital Stays, for the Treatment of Deep Vein Thrombosis

Real-World Data Confirms Safety and Efficacy Profile of XARELTO, With Shorter Hospital Stays, for the Treatment of Deep Vein Thrombosis December 7, 2015 Real-World Data Confirms Safety and Efficacy Profile of XARELTO, With Shorter Hospital Stays, for the Treatment of Deep Vein Thrombosis XALIA is First Prospective Study to Confirm Benefit

More information

Patient frequently asked questions

Patient frequently asked questions Patient frequently asked questions What is atrial fibrillation?...2 What are dabigatran and rivaroxaban and what are they used for?...2 Which is better, dabigatran or rivaroxaban?...2 For patients with

More information

Management for Deep Vein Thrombosis and New Agents

Management for Deep Vein Thrombosis and New Agents Management for Deep Vein Thrombosis and New Agents Mark Malesker, Pharm.D., FCCP, FCCP, FASHP, BCPS Professor of Pharmacy Practice and Medicine Creighton University 5 th Annual Creighton Cardiovascular

More information

Deep Vein Thrombosis (DVT)

Deep Vein Thrombosis (DVT) Patient Information Service Bristol Royal Infirmary Deep Vein Thrombosis (DVT) Thrombosis Clinic 0117 342 4684 Respecting everyone Embracing change Recognising success Working together Our hospitals. This

More information

ORAL ANTICOAGULANTS RIVAROXABAN (XARELTO) FOR PULMONARY EMBOLISM (PE)

ORAL ANTICOAGULANTS RIVAROXABAN (XARELTO) FOR PULMONARY EMBOLISM (PE) ORAL ANTICOAGULANTS RIVAROXABAN (XARELTO) FOR PULMONARY EMBOLISM (PE) Information Leaflet Your Health. Our Priority. Page 2 of 6 What Are Anticoagulants And What Do They Do? This information leaflet has

More information

New Oral Anticoagulants

New Oral Anticoagulants New Oral Anticoagulants Tracy Minichiello, MD Associate Professor of Medicine Chief, San FranciscoVA Anticoagulation and Thrombosis Service Ansell, J. Hematology Copyright 2010 American Society of Hematology.

More information

Atrial fibrillation (non-valvular) and reducing the risk of a stroke Management Options Brief Decision Aid

Atrial fibrillation (non-valvular) and reducing the risk of a stroke Management Options Brief Decision Aid Atrial fibrillation (non-valvular) and reducing the risk of a stroke Management Options Brief Decision Aid Atrial fibrillation (AF) increases your risk of having a stroke (a blood clot in the brain). From

More information

Prostate Assessment Pathway Prostate Biopsy Alerts

Prostate Assessment Pathway Prostate Biopsy Alerts Prostate Assessment Pathway Prostate Biopsy Alerts Guidelines for the Management of Patient Preparation, Medications and Complications July 2015 Table of Contents Roles and Responsibilities. 1 SECTION

More information

HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) RIVAROXABAN RECOMMENDED see specific recommendations for licensed indications below

HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) RIVAROXABAN RECOMMENDED see specific recommendations for licensed indications below Name: generic (trade) Rivaroxaban (Xarelto ) HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) RIVAROXABAN RECOMMENDED see specific recommendations for licensed indications below What it is Indications

More information

Atrial Fibrillation. Patient Information. 828361 Dec 19-12

Atrial Fibrillation. Patient Information. 828361 Dec 19-12 Atrial Fibrillation Patient Information 828361 Dec 19-12 Contents Introduction 1 Treatment & decrease stroke options 2 Information for people who are taking warfarin (Coumadin ) 5 Information for people

More information

Rivaroxaban for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE)

Rivaroxaban for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) Rivaroxaban for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) This leaflet aims to answer your questions about rivaroxaban that may be prescribed for you when you are diagnosed

More information

Devang M. Desai, MD, FACC, FSCAI Chief of Interventional Cardiology Director of Cardiac Catheterization Lab St. Mary s Hospital and Regional Medical

Devang M. Desai, MD, FACC, FSCAI Chief of Interventional Cardiology Director of Cardiac Catheterization Lab St. Mary s Hospital and Regional Medical Devang M. Desai, MD, FACC, FSCAI Chief of Interventional Cardiology Director of Cardiac Catheterization Lab St. Mary s Hospital and Regional Medical Center A.Fib affects 2.2 million Americans. The lifetime

More information

Rivaroxaban: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF

Rivaroxaban: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF Leeds Rivaroxaban: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF Amber Drug Level 3 (amber drug with monitoring requirements) We have started your

More information

Reducing Adverse Drug Events With Anti Coagulation Clinics. McFarland Clinic. McFarland Protime Clinic 09/05/12

Reducing Adverse Drug Events With Anti Coagulation Clinics. McFarland Clinic. McFarland Protime Clinic 09/05/12 Reducing Adverse Drug Events With Anti Coagulation Clinics Dr. Donald Skinner, MD McFarland Clinic 182 Physicians (149 Shareholders) 40 Mid Level Providers 13 Administrators/Executive Directors 1,200 Support

More information

A PATIENT S GUIDE TO SECONDARY PREVENTION IN ACUTE CORONARY SYNDROME (ACS)

A PATIENT S GUIDE TO SECONDARY PREVENTION IN ACUTE CORONARY SYNDROME (ACS) A PATIENT S GUIDE TO SECONDARY PREVENTION IN ACUTE CORONARY SYNDROME (ACS) This medicine is subject to additional monitoring. This will allow quick identification of new safety information. If you get

More information

Guide to Warfarin Therapy

Guide to Warfarin Therapy Page 1 of 8 Guide to Warfarin Therapy Treatment to Prevent Blood Clots If you are deaf or hard of hearing, please let us know. We provide many free services including sign language interpreters, oral interpreters,

More information

Oxford Anticoagulation & Thrombosis Service Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

Oxford Anticoagulation & Thrombosis Service Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) Oxford University Hospitals NHS Trust Oxford Anticoagulation & Thrombosis Service Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) Information for people with a blood clot (thrombus) What is this

More information

The Children s Hospital Being on Warfarin Information for parents and children

The Children s Hospital Being on Warfarin Information for parents and children The Children s Hospital Being on Warfarin Information for parents and children Contents What is warfarin? The coagulation (blood clotting) system How warfarin works The INR test Why you might need to take

More information

1/7/2012. Objectives. Epidemiology of Atrial Fibrillation(AF) Stroke in AF. Stroke Risk Stratification in AF

1/7/2012. Objectives. Epidemiology of Atrial Fibrillation(AF) Stroke in AF. Stroke Risk Stratification in AF Objectives Atrial Fibrillation and Prevention of Thrombotic Complications: Therapeutic Update Andrea C. Flores Pharm.D Pharmacy Resident at the Miami VA Healthcare System Review the epidemiology, pathophysiology

More information

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Family physician with Rivergrove Medical Clinic Practice in the north end since 1985 Medical Director of the Wellness

More information