Anticoagulants. Anticoagulants Definition. When are blood clots GOOD? Where and why do blood clots occur? 6/12/2014
|
|
- Ralph Evans
- 8 years ago
- Views:
Transcription
1 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 Is this accurate? Many different types of drugs can alter clotting What do they really do? What are clot busters? 1 2 When are blood clots GOOD? Where and why do blood clots occur? Economy class syndrome Clots in the legs Lungs pulmonary embolus Brain stroke Atrial fibrillation stroke Any condition with Stasis, injury, coag 3 4 1
2 When are Blood Clots BAD? When they block the flow of blood Blood clotting A complex series of events Balance clotting with bleeding Balance clotting with tissue damage Evolution of a bruise Trauma Bleeding Clotting Bleeding Clotting Natural elements in the body maintain this balance 5 6 Types of Anticoagulants Injections versus Oral Medications Medications which affect platelets, ASA Heparin Enoxaparin or Lovenox Warfarin or Coumadin Dabigatran or Pradaxa Rivaroxaban or Xarelto Apixaban or Eliquis tpa or Activase Warfarin Coumadin 1920 s prairies of Canada and Northern Plains Previous healthy cattle started dying from internal bleeding Devastating economic blow to farmers Discovered that cattle fed damp sweet clover hay which normally would have been discarded 10 years later a local farmer went to Karl Link who was able after a few years to crystallize the active substance 7 8 2
3 Wisconsin Alumni Research Foundation(WARF) WARFARIN 9 10 Warfarin 1941 patent rights for first anticoagulant 1948 first promoted as a rodenticide 1954 approved for human use 1955 Dwight Eisenhower received warfarin after heart attack, What was good for a war hero and the President of the United States must be good for all, despite being a rat poison 11 3
4 Why is my dosage of warfarin so different from Joe s or Mary s? Warfarin Dosing What influences the dose? Must be individualized! What about my diet? How do we manage complicated medication regimens and avoid drug interactions? What to look for? Age, sex, weight, smoking? What about travel? What about activities? Warfarin and Genetics In search of personalized medicine
5 Warfarin and Genetics Genetics accounts for about 40% of dose prediction Weight and age account for 16% Other factors make up the rest If the average dose for a Caucasian is 5 mg The dose for an Asian patient is 2.5 mg The dose for an African American is 7.5 mg Not routinely useful to genotype Diet and Warfarin Interactions with Warfarin Do not need to avoid vitamin K containing foods They are good for you! We can adjust the warfarin dose if necessary Maintain relative consistency Do not weigh or measure portions Biggest dietary influence is not eating anything due to an illness
6 Drug Interactions with Warfarin (one plus one does not always = two) Some drugs make warfarin work too much Some drugs do not allow warfarin to work Timing can be different when an interaction occurs can be different for different medicines Influence of other factors Stomach irritation, ulcers Most common drug interactions Antibiotics and other anti infective drugs NSAIDs non steroidal anti inflammatory drugs Advil (ibuprofen), Alleve (naproxen) Heart Medicines, for example Cordarone How to manage interactions? Avoid them! Nutritional supplements Herbal medications Over the counter medications (OTC) Ask lots of questions! Pharmacist Use an alternative agent that does not interact Monitor more closely and change dose of warfarin if needed
7 Warfarin Monitoring Laboratory Physician Office Anticoagulation Clinic Home Testing Home Monitoring Point of care INR testing Frequency of monitoring Warfarin and Bleeding Warfarin does not cause bleeding! Requires some type of injury Trauma Irritation Direct pressure Ice for bruises Call 911 if does not stop MedicAlert
8 Pros and Cons of Warfarin Clot Busters Pros Able to monitor Lots of experience Antidote (vit K) Inexpensive Very effective Few side effects Well absorbed Long duration of action Once daily Cons Need to monitor Drug interactions Food interactions Bleeding Care with surgery Avoid in pregnancy New Anticoagulants New Anticoagulants
9 Use of new anticoagulants Drug Eliquis apixaban Pradaxa rivaroxaban Xarelto dabigatran Atrial fibrillation Treatment DVT/PE Prevention of DVT/PE during surgery New Anticoagulants Pros No monitoring Fewer drug interactions Few diet interactions Short duration of action Effective and better than warfarin for some Cons Expensive Unable to measure Short duration of action, risk if miss a dose No antidote Dangerous with kidney problems Bleeding in stomach (Pradaxa, Xarelto ) Avoid in pregnancy Twice daily (Pradaxa, Eliquis ) 35 9
10 Natural anticoagulants? Garlic Ginseng Fish oils Vitamin E Ginger Dong quai Feverfew Most are reported to have an effect on platelets Some are reported to influence warfarin and INR Different formulations make generalized conclusions difficult Approaches to Anticoagulant Therapy Vascular Injury Risk Factor Reduction Platelet Adherence Aggregation Platelet Inhibitors Coagulation Activation Thrombin Generation Fibrin Formation Anticoagulants Plasmin Generation Fibrinolysis Thrombolytics 40 10
11 Resources ClotConnect ClotCare American Heart Association National Blood Clot Alliance _more.htm Individual health plans, e.g. Kaiser Foundation 41 11
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 informationA 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 informationAnticoagulants 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 informationAtrial 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 informationMCHENRY 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 informationTreatment 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 informationTraditional 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 informationSudden 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 informationRx 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 informationTreatment 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 informationCOMPARISON 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 informationPatient 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 informationWarfarin. (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 informationNew Anticoagulation Options for Stroke Prevention in Atrial Fibrillation. Joy Wahawisan, Pharm.D., BCPS April 25, 2012
New Anticoagulation Options for Stroke Prevention in Atrial Fibrillation Joy Wahawisan, Pharm.D., BCPS April 25, 2012 Stroke in Atrial Fibrillation % Stroke 1991;22:983. Age Range (years) CHADS 2 Risk
More informationNnEeWw DdEeVvEeLlOoPpMmEeNnTtSs IiıNn OoRrAaLl AaNnTtIiıCcOoAaGgUuLlAaTtIiıOoNn AaNnDd RrEeVvEeRrSsAaLl
NnEeWw DdEeVvEeLlOoPpMmEeNnTtSs IiıNn OoRrAaLl AaNnTtIiıCcOoAaGgUuLlAaTtIiıOoNn AaNnDd RrEeVvEeRrSsAaLl Mikele Wissing, RN June 2014 Introduction until recently, was the unrivaled medication for treatment
More informationAFib (short for atrial fibrillation) is the most common type of irregular heartbeat, affecting literally millions of men and women
What is atrial fibrillation? AFib (short for atrial fibrillation) is the most common type of irregular heartbeat, affecting literally millions of men and women What is atrial fibrillation? AFib occurs
More informationDaily 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 informationIntroduction. 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 informationIntroduction 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 informationAnticoagulation and Reversal
Anticoagulation and Reversal John Howard, PharmD, BCPS Clinical Pharmacist Internal Medicine Affiliate Associate Clinical Professor South Carolina College of Pharmacy Disclosures I have no Financial, Industry,
More informationCritical Bleeding Reversal Protocol
Critical Bleeding Reversal Protocol Coagulopathy, either drug related or multifactorial, is a major contributing factor to bleeding related mortality in a variety of clinical settings. Standard therapy
More informationBlood-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 informationProgram 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 informationThrough 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 informationLiving 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 informationORAL 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 informationNICE TA 275: Apixaban for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation
Service Notification in response to DHSSPS endorsed NICE Technology Appraisals NICE TA 275: Apixaban for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation 1
More informationACUTE 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 informationORAL 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 informationGuide 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 informationThe New Oral Anticoagulants: When and When Not to Use Them Philip C. Comp, M.D., Ph.D. Professor of Medicine, University of Oklahoma Health Sciences
The New Oral Anticoagulants: When and When Not to Use Them Philip C. Comp, M.D., Ph.D. Professor of Medicine, University of Oklahoma Health Sciences Center September 25, 2015 Question: With which of the
More informationPrevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (AF) with one or more risk factors
News Release For use outside the US and UK only Bayer Pharma AG 13342 Berlin Germany Tel. +49 30 468-1111 www.bayerpharma.com Bayer s Xarelto Approved in the EU for the Prevention of Stroke in Patients
More informationEDUCATIONAL COMMENTARY RAT POISON, GENETICS, AND MOLECULAR BIOLOGY: WHITHER THE FUTURE OF COAGULATION TESTING?
THE FUTURE OF COAGULATION TESTING? Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click on Earn CE Credits
More informationAntiplatelet 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 information3/25/14. 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 informationNew Anticoagulants: What to Use What to Avoid
New Anticoagulants: What to Use What to Avoid Bruce Davidson, MD, MPH Clinical Professor of Medicine Pulmonary and Critical Care Medicine Division University of Washington School of Medicine Seattle USA
More informationRivaroxaban (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 informationAtrial 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 informationWarfarin 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 informationWhat 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 informationMEDICATION 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 informationUse of Novel Oral Anticoagulants (NOACs) and the new DAWN modules at Scripps
Use of Novel Oral Anticoagulants (NOACs) and the new DAWN modules at Scripps Cheryl Ea, Pharm D. Anticoagulation Services Scripps Clinic and Scripps Green Hospital La Jolla, California Pharmacist Management
More informationAnticoagulation 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 informationTSOAC 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 informationCoumadin Interaction With Food Vitamins
Coumadin Interaction With Food Vitamins 1 inr range for warfarin therapy 2 can you take viagra and coumadin with tylenol 3 coumadin and alcohol juice interaction between 4 generic warfarin vs coumadin
More informationFAQs 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 informationNew Oral Anticoagulants Increase Risk for Gastrointestinal Bleeding - A Systematic Review and Meta-Analysis
New Oral Anticoagulants Increase Risk for Gastrointestinal Bleeding - A Systematic Review and Meta-Analysis Holster IL, Valkhoff VE, Kuipers EJ, Tjwa ET Departments of Gastroenterology and Hepatology,
More informationAnticoagulant 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 informationProstate 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 informationV1: Draft Nov 2014. Making decisions... about anticoagulation for stroke prevention in atrial fibrillation. www.weahsn.net
V1: Draft Nov 2014 Making decisions... about anticoagulation for stroke prevention in atrial fibrillation www.weahsn.net is this pack for? pack and booklet is for people with AF. It is designed to help
More informationHow To Treat Aneuricaagulation
Speaker Introduction Jessica Wilhoite, PharmD, BCACP Doctor of Pharmacy: Purdue University Postgraduate Residency Training: PGY1 Pharmacy Practice St. Vincent Hospital PGY2 Ambulatory Care St. Vincent
More informationTitle of Guideline. Thrombosis Pharmacist)
Title of Guideline Contact Name and Job Title (author) Guideline for patients receiving Rivaroxaban (Xarelto ) requiring Emergency Surgery or treatment for Haemorrhage Julian Holmes (Haemostasis and Thrombosis
More informationDorset 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 informationwhat 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 informationGRASP-AF Coming to a PCT near you.
GRASP-AF Coming to a PCT near you. ADAS Anticoagulation dosing advisory service Blackpool Teaching Hospitals Trust Sean O'Brien; Anticoagulation Specialist BMS Grasp-AF and the implications on our Anticoagulation
More informationReversing the New Anticoagulants
Reversing the New Anticoagulants Disclosure Susan C. Lambe, MD Assistant Clinical Professor Department of Emergency Medicine University of California, San Francisco Roadmap for today 1 Roadmap for today
More informationUW 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 informationWarfarin 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 informationDVT/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 informationAtrial Fibrillation Patient Survey Online survey of AFib Patients 65+ Exploring Experiences with the Diagnosis and Treatment of AFib.
Atrial Fibrillation Patient Survey Online survey of AFib Patients 65+ Exploring Experiences with the Diagnosis and Treatment of AFib September 2012 Objectives and Methodology Objectives Achieve better
More informationAtrial 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 informationBlood-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 blood clots forming. They are often prescribed after
More informationSession 3 Topics. Argatroban. Argatroban. Drug Use and Adverse Effects. Laboratory Monitoring of Anticoagulant Therapy
~~Marshfield Labs Presents~~ Laboratory Monitoring of Anticoagulant Therapy Session 3 of 4 Michael J. Sanfelippo, M.S. Technical Director, Coagulation Services Session 3 Topics Direct Thrombin Inhibitors:
More informationPulmonary Embolism Treatment Update
UC SF Pulmonary Embolism Treatment Update Jeffrey Tabas, MD Professor UCSF School of Medicine Emergency Department San Francisco General Hospital sf g h Disclosure No Financial Relationships to Disclose
More informationInvestor News. Not intended for U.S. and UK media
Investor News Not intended for U.S. and UK media Bayer AG Investor Relations 51368 Leverkusen Germany www.investor.bayer.com Bayer s Xarelto (Rivaroxaban) Approved for the Treatment of Pulmonary Embolism
More informationDisclosures. Objective (NRHS) Self Assessment #2
Development and Implementation of a Protocol for Reversing the Effects of Anticoagulants for Use in a Community Hospital Samantha Sepulveda, Pharm.D. PGY1 Pharmacy Resident Norman Regional Health System
More informationThe 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 informationVenous Thromboembolism: Long Term Anticoagulation. Dan Johnson, Pharm.D.
Venous Thromboembolism: Long Term Anticoagulation Dan Johnson, Pharm.D. Disclosures No financial relationships with products discussed Off-label use of drug therapy always discussed Objectives Review clinical
More informationCauses Of High Coumadin Level And Symptoms
Causes Of High Coumadin Level And Symptoms coumadin toxicity guidelines skin coumadin diet pdf university of michigan coumadin diet espanol guide coumadin and vitamin k pdf reversal time coumadin warfarin
More informationINTRODUCTION Thrombophilia deep vein thrombosis DVT pulmonary embolism PE inherited thrombophilia
INTRODUCTION Thrombophilia (Hypercoagulability) is a condition in which a person forms blood clots more than normal. Blood clots may occur in the arms or legs (e.g., deep vein thrombosis DVT), the lungs
More informationA PRACTICAL REVIEW OF THE NOVEL ORAL ANTICOAGULANTS
A PRACTICAL REVIEW OF THE NOVEL ORAL ANTICOAGULANTS BRIAN CRYDER, PHARMD BCACP LEARNING OBJECTIVES AS A RESULT OF THIS PRESENTATION, THE AUDIENCE WILL BE ABLE TO 1. DISCUSS THE KEY DIFFERENCES BETWEEN
More informationInpatient 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 informationMEDICATION 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 informationMedication Policy Manual. Topic: Eliquis, apixaban Date of Origin: July 12, 2013. Committee Approval Date: July 11, 2014 Next Review Date: July 2015
Medication Policy Manual Policy No: dru313 Topic: Eliquis, apixaban Date of Origin: July 12, 2013 Committee Approval Date: July 11, 2014 Next Review Date: July 2015 Effective Date: August 1, 2014 IMPORTANT
More informationCommittee Approval Date: September 12, 2014 Next Review Date: September 2015
Medication Policy Manual Policy No: dru361 Topic: Pradaxa, dabigatran Date of Origin: September 12, 2014 Committee Approval Date: September 12, 2014 Next Review Date: September 2015 Effective Date: November
More informationSTROKE 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 informationExecutive Summary. Motive for the request for advice
Executive Summary Motive for the request for advice Currently nearly 400,000 people in the Netherlands are being treated with anticoagulants of a type Vitamin K antagonists (VKAs). Although VKAs are very
More informationHow To Get A Dose Of Bayer Healthcare'S Oral Anticoagulant, Xarelto
News Release FOR UK HEALTHCARE MEDIA ONLY Bayer HealthCare Bayer plc Bayer House Strawberry Hill Newbury Berkshire, RG14 1JA www.bayer.co.uk Bayer s Xarelto (rivaroxaban) Recommended by CHMP for EU Approval
More informationGuide 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 informationNew Oral Anticoagulant Drugs What monitoring if any is required?
New Oral Anticoagulant Drugs What monitoring if any is required? Michelle Williamson Supervising Scientist High Throughput Haematology Pathology Queensland PAH Laboratory Overview Background What new oral
More informationVenous Thrombosis and Pulmonary Embolism Treatment with Rivaroxaban
Venous Thrombosis and Pulmonary Embolism Treatment with Rivaroxaban Information for patients and families Read this booklet to learn: about venous thrombosis and pulmonary embolism how the medicine Rivaroxaban
More informationUpdate 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 informationORAL 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 informationFailure or significant adverse effects to all of the alternatives: Eliquis and Xarelto
This policy has been developed through review of medical literature, consideration of medical necessity, generally accepted medical practice standards, and approved by the IEHP Pharmacy and Therapeutics
More information- Understand Datamonitor's independent appraisal of marketed oral anticoagulant brands and key pipeline agents indicated for treating SPAF.
Brochure More information from http://www.researchandmarkets.com/reports/2236696/ Product Profiles: Stroke Prevention in Atrial Fibrillation - Uptake slower than expected for the first warfarin alternatives,
More informationLAMC Reversal Agent Guideline for Anticoagulants 2013. Time to resolution of hemostasis (hrs) Therapeutic Options
LAMC Reversal Agent Guideline for Anticoagulants 2013 Medication resolution of hemostasis (hrs) Intervention Administration Instructions Heparin 3-4 Protamine 1mg IV for every 100 units of heparin Slow
More informationDOACs. What s in a name? or TSOACs. Blood Clot. Darra Cover, Pharm D. Clot Formation DOACs work here. Direct Oral AntiCoagulant
DOACs NOACs or TSOACs Generic Name DOACs Brand Name Mechanism of Action Direct Xa Inhibitor Direct Thrombin Inhibitor Dabigatran Pradaxa X Rivaroxaban Xarelto X Darra Cover, Pharm D Apixaban Eliquis X
More informationAnticoagulation Essentials! Parenteral and Oral!
Anticoagulation Essentials! Parenteral and Oral! Anti-Xa and Anti-IIa! Parenteral Anticoagulants! Heparin family (indirect anti-xa and anti-iia):! UFH! LMWH (enoxaparin, fondaparinux)! Direct thrombin
More informationCoumadin Diet Restrictions In Spanish Education
Coumadin Diet Restrictions In Spanish Education coumadin dose formula high coumadin interactions with herbs diet inr range when on coumadin or ptt normal Baclofen 10 Mg Dose Snort coumadin dose guidelines
More informationBrand 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 informationOptimizing Anticoagulation Selection for Your Patient. C. Andrew Brian MD, FACC NCVH 2015
Optimizing Anticoagulation Selection for Your Patient C. Andrew Brian MD, FACC NCVH 2015 Who Needs to Be Anticoagulated and What is the Patient s Risk? 1. Atrial Fibrillation ( nonvalvular ) 2. What regimen
More informationAndrew Stoessel, PharmD PGY-1 Pharmacy Practice Resident Jackson Memorial Hospital
Andrew Stoessel, PharmD PGY-1 Pharmacy Practice Resident Jackson Memorial Hospital Objectives Discuss rationale in analyzing prescribing practices for direct oral anticoagulants Outline current prescribing
More informationStop the Bleeding: Management of Drug-induced Coagulopathy. Stacy A. Voils, PharmD, BCPS Critical Care Specialist, Neurosurgery
Stop the Bleeding: Management of Drug-induced Coagulopathy Stacy A. Voils, PharmD, BCPS Critical Care Specialist, Neurosurgery Objectives Discuss contemporary management of warfarin reversal in patients
More informationSTARTING, SWITCHING OR STOPPING NEW ORAL ANTICOAGULANTS: A Practical Approach
STARTING, SWITCHING OR STOPPING NEW ORAL ANTICOAGULANTS: A Practical Approach Jeffrey I Weitz, MD, FRCP(C), FACP Professor of Medicine and Biochemistry McMaster University Canada Research Chair in Thrombosis
More informationINTRODUCTION Thrombophilia deep vein thrombosis DVT pulmonary embolism PE inherited thrombophilia
INTRODUCTION Thrombophilia (Hypercoagulability) is a condition in which a person forms blood clots more than normal. Blood clots may occur in the arms or legs (e.g., deep vein thrombosis DVT), the lungs
More informationLocal Steroid Injections to Joints and Soft Tissues. Rheumatology Patient Information Leaflet
Local Steroid Injections to Joints and Soft Tissues Rheumatology Patient Information Leaflet Welcome to The Dudley Group Rheumatology department. This leaflet will provide you with information about what
More informationAnalyzing 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 informationManagement 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 informationNewer Anticoagulants and Newer Diabetic Drug Classes. Nicole N. Nguyen, PharmD Senior Clinical Pharmacist Health Care Services August 21, 2013
Newer Anticoagulants and Newer Diabetic Drug Classes Nicole N. Nguyen, PharmD Senior Clinical Pharmacist Health Care Services August 21, 2013 Apixaban Newer Anticoagulants Dabigatran etexilate Rivaroxaban
More informationUltrasound-guided steroid injections in joints and soft tissues. Rheumatology Patient Information Leaflet
Ultrasound-guided steroid injections in joints and soft tissues Rheumatology Patient Information Leaflet Welcome to The Dudley Group Rheumatology department. This leaflet will provide you with information
More information