Anticoagulant Drug Use
... For the treatment of DVT/PE, LMWH should be administered (with the initiation of warfarin) for at least 5 days and/or until there are 2 consecutive therapeutic INRs The dose of enoxaparin for treatment of DVT/PE, unstable angina and non-ST segment elevation myocardial infarction (UA/NSTEMI) is 1mg/k ...
... For the treatment of DVT/PE, LMWH should be administered (with the initiation of warfarin) for at least 5 days and/or until there are 2 consecutive therapeutic INRs The dose of enoxaparin for treatment of DVT/PE, unstable angina and non-ST segment elevation myocardial infarction (UA/NSTEMI) is 1mg/k ...
NURO 544 Module 8 Cardiology II
... Identify the coagulation factors affected by: • Unfractionated Heparin • LMWH – enoxaparin, dalteparin ...
... Identify the coagulation factors affected by: • Unfractionated Heparin • LMWH – enoxaparin, dalteparin ...
History of anticoagulant therapy
... – FDA approval 2010/11: postop VTE prophylaxis, stroke prevention in Afib, treatment of VTE • Apixaban (Eliquis®) – Xa inhibitor – FDA approval 2012: stroke prevention in Afib; approved 2014 for VTE prophylaxis after major ...
... – FDA approval 2010/11: postop VTE prophylaxis, stroke prevention in Afib, treatment of VTE • Apixaban (Eliquis®) – Xa inhibitor – FDA approval 2012: stroke prevention in Afib; approved 2014 for VTE prophylaxis after major ...
PLASMA FRACTIONS (cont`d)
... thrombocytopenia should be considered to be HIT. any new thrombus can be result of heparin. HIT treated by discontinuance of heparin & administration of direct thrombin inhibitor or fondaparinux ...
... thrombocytopenia should be considered to be HIT. any new thrombus can be result of heparin. HIT treated by discontinuance of heparin & administration of direct thrombin inhibitor or fondaparinux ...
Venous Thromboembolism UPDATES AND GUIDELINES Steve Zanders, DO FCCP Intensivist
... Hey, What About Good Ol’ Aspirin? ...
... Hey, What About Good Ol’ Aspirin? ...
Frequently Asked Questions - Low Molecular Weight Heparins
... Unlike the situation using unfractionated calcium heparin where the risk can be ~ 5% between days 4 and 14 of treatment, the risk with LMWH is < 1% hence routine platelet count monitoring is not required. ...
... Unlike the situation using unfractionated calcium heparin where the risk can be ~ 5% between days 4 and 14 of treatment, the risk with LMWH is < 1% hence routine platelet count monitoring is not required. ...
Blood clots
... (Lehne, p 601) is used to determine the degree of anticoagulation induced by heparin therapy Normal healthy people not on anticoagulation therapy have an aPTT of about 40 seconds People on heparin for anticoagulation typically have a goal of aPTT in the range of 40 – 60 seconds Labs must be ch ...
... (Lehne, p 601) is used to determine the degree of anticoagulation induced by heparin therapy Normal healthy people not on anticoagulation therapy have an aPTT of about 40 seconds People on heparin for anticoagulation typically have a goal of aPTT in the range of 40 – 60 seconds Labs must be ch ...
The New Oral Anticoagulants and a New Use for Arixtra
... Surgery while on medication Dabigatran (100% renal) Rivaroxaban (65% renal clearance) Apixaban (25% renal clearance) When to stop the medication preoperatively depends on the medication and renal function. ...
... Surgery while on medication Dabigatran (100% renal) Rivaroxaban (65% renal clearance) Apixaban (25% renal clearance) When to stop the medication preoperatively depends on the medication and renal function. ...
savaysa
... • Patient weight ≤60 kg: 30 mg once daily • Concomitant therapy with specific P-gp inhibitors: 30 mg once daily • Nonvalvular atrial fibrillation: Oral: 60 mg once daily ...
... • Patient weight ≤60 kg: 30 mg once daily • Concomitant therapy with specific P-gp inhibitors: 30 mg once daily • Nonvalvular atrial fibrillation: Oral: 60 mg once daily ...
Pradaxa Birthday
... • Class I • Dabigatran is useful as an alternative to warfarin for the prevention of stroke and systemic thromboembolism in patients with paroxysmal to permanent AF and risk factors for stroke or systemic embolization who do not have a prosthetic heart valve or hemodynamically significant valve dise ...
... • Class I • Dabigatran is useful as an alternative to warfarin for the prevention of stroke and systemic thromboembolism in patients with paroxysmal to permanent AF and risk factors for stroke or systemic embolization who do not have a prosthetic heart valve or hemodynamically significant valve dise ...
Pharmacology Objectives 12
... due to risk of hemorrhage. Heparin does not cross the placenta and is not excreted in milk. LMWH is eliminated by the kidney and is not given in renal insufficiency. Warfarin – is given orally because it is promptly and completely absorbed in the GI tract. Warfarin is highly protein bound (98-99%) a ...
... due to risk of hemorrhage. Heparin does not cross the placenta and is not excreted in milk. LMWH is eliminated by the kidney and is not given in renal insufficiency. Warfarin – is given orally because it is promptly and completely absorbed in the GI tract. Warfarin is highly protein bound (98-99%) a ...
Spontaneous Perinephric Hematoma with Newer Oral
... Factor Xa inhibitors apixaban and rivaroxaban are newer oral anticoagulants that were approved for the treatment of non-valvular atrial fibrillation in October 2010 and Venous Thromboembolism (VTE), specifically Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), in April 2014. When compared t ...
... Factor Xa inhibitors apixaban and rivaroxaban are newer oral anticoagulants that were approved for the treatment of non-valvular atrial fibrillation in October 2010 and Venous Thromboembolism (VTE), specifically Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), in April 2014. When compared t ...
Direct Thrombin Inhibitors - New England Journal of Medicine
... argatroban and dabigatran, is limited to phase 2 studies. Four parenteral DTIs have been approved by the Food and Drug Administration (FDA) in North America: hirudin and argatroban for the treatment of heparin-induced thrombocytopenia, bivalirudin as an alternative to heparin in percutaneous coronar ...
... argatroban and dabigatran, is limited to phase 2 studies. Four parenteral DTIs have been approved by the Food and Drug Administration (FDA) in North America: hirudin and argatroban for the treatment of heparin-induced thrombocytopenia, bivalirudin as an alternative to heparin in percutaneous coronar ...
Latest data on management of bleeding in patients taking DOACs
... Idarucizumab showed immediate, complete and sustained reversal of dabigatran anticoagulation ...
... Idarucizumab showed immediate, complete and sustained reversal of dabigatran anticoagulation ...
Do not
... • However it has poor dose-response curve: • highly protein bound • Hepatic metabolism via the CYP450 system: Single nucleotide polymorphisms in CYP2C9 and VKORC1 • a novel personalized prediction tool for warfarin initiation found no influence of CYP2C9 or VKORC1 genotypes on time to stable anticoa ...
... • However it has poor dose-response curve: • highly protein bound • Hepatic metabolism via the CYP450 system: Single nucleotide polymorphisms in CYP2C9 and VKORC1 • a novel personalized prediction tool for warfarin initiation found no influence of CYP2C9 or VKORC1 genotypes on time to stable anticoa ...
File - Developing Anaesthesia
... which is an orally active direct Factor Xa inhibitor. It offers some significant therapeutic advantages over warfarin, but is more problematic with respect to its haemorrhagic complications, as there is no currently available antidote/ reversal agent. Principle differences from dabigatran include: ...
... which is an orally active direct Factor Xa inhibitor. It offers some significant therapeutic advantages over warfarin, but is more problematic with respect to its haemorrhagic complications, as there is no currently available antidote/ reversal agent. Principle differences from dabigatran include: ...
Chapter 4 Cultural, Legal, & Ethical Considerations
... Heparin Absorption: Quickly absorbed after injection Distribution: Does not cross placenta or enter breast ...
... Heparin Absorption: Quickly absorbed after injection Distribution: Does not cross placenta or enter breast ...
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 requiring INR monitoring and dose adjustments. Choosing between warfarin and dabigatran can ...
... 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 requiring INR monitoring and dose adjustments. Choosing between warfarin and dabigatran can ...
A Year in Review: Top New Drugs for 2010
... due to the risk of bleeding; consider longer times for patients undergoing major surgery, spinal puncture, or insertion of a spinal or epidural catheter or port. If surgery cannot be delayed, the risk of bleeding is elevated; weigh risk of bleeding with urgency of procedure. Bleeding risk can be ass ...
... due to the risk of bleeding; consider longer times for patients undergoing major surgery, spinal puncture, or insertion of a spinal or epidural catheter or port. If surgery cannot be delayed, the risk of bleeding is elevated; weigh risk of bleeding with urgency of procedure. Bleeding risk can be ass ...
Chapter 48 Antidysrhythmic Drugs
... RECOMMENDATION: Health care professionals and institutions involved in performing spinal/epidural anesthesia or spinal punctures should determine, as part of a pre-procedure checklist, whether a patient is receiving anticoagulants and identify the appropriate timing of enoxaparin dosing in relation ...
... RECOMMENDATION: Health care professionals and institutions involved in performing spinal/epidural anesthesia or spinal punctures should determine, as part of a pre-procedure checklist, whether a patient is receiving anticoagulants and identify the appropriate timing of enoxaparin dosing in relation ...
PPT, 6.99MB
... • Commercial preparations are extracted from beef lung or hog intestine. • Heparin fragments (e.g. enoxaparin, dalteparin) or a synthetic pentasaccharide (fondaparinux), are referred to as low-molecular-weight heparins (LMWHs), • LMWHs are often used in place of unfractionated heparin, which is rese ...
... • Commercial preparations are extracted from beef lung or hog intestine. • Heparin fragments (e.g. enoxaparin, dalteparin) or a synthetic pentasaccharide (fondaparinux), are referred to as low-molecular-weight heparins (LMWHs), • LMWHs are often used in place of unfractionated heparin, which is rese ...
Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naı¨ve atrial fibrillation patients
... has changed with the availability of non-vitamin K antagonist oral anticoagulants (NOAC). Several NOACs now exist, offering similar (or better) effectiveness, safety, and convenience to the vitamin K antagonists (VKAs);1 those with evidence from large randomized trials of stroke prevention in patien ...
... has changed with the availability of non-vitamin K antagonist oral anticoagulants (NOAC). Several NOACs now exist, offering similar (or better) effectiveness, safety, and convenience to the vitamin K antagonists (VKAs);1 those with evidence from large randomized trials of stroke prevention in patien ...
GPIIb - IIIa - ICU education
... clinicians consider the risk of HIT to be > 1%, we suggest that platelet count monitoring be performed every 2 or 3 days from day 4 to day 1For patients receiving heparin in whom clinicians consider the risk of HIT to be > 1%, we suggest that platelet count monitoring be performed every 2 or 3 days ...
... clinicians consider the risk of HIT to be > 1%, we suggest that platelet count monitoring be performed every 2 or 3 days from day 4 to day 1For patients receiving heparin in whom clinicians consider the risk of HIT to be > 1%, we suggest that platelet count monitoring be performed every 2 or 3 days ...
DVT and PE Pharmacotherapy Teaching Slides
... • thrombolytics • surgery (endarterectomy, can be life saving, specialized centres) • Greenfield Filters (px) ...
... • thrombolytics • surgery (endarterectomy, can be life saving, specialized centres) • Greenfield Filters (px) ...
Discovery and development of direct thrombin inhibitors
Direct thrombin inhibitors (DTIs) are a class of anticoagulant drugs that can be used to prevent and treat embolisms and blood clots caused by various diseases. They inhibit thrombin, a serine protease which affects the coagulation cascade in many ways. DTIs have undergone rapid development since the 90's. With technological advances in genetic engineering the production of recombinant hirudin was made possible which opened the door to this new group of drugs. Before the use of DTIs the therapy and prophylaxis for anticoagulation had stayed the same for over 50 years with the use of heparin derivatives and warfarin which have some well known disadvantages. DTIs are still under development, but the research focus has shifted towards factor Xa inhibitors, or even dual thrombin and fXa inhibitors that have a broader mechanism of action by both inhibiting factor IIa (thrombin) and Xa. A recent review of patents and literature on thrombin inhibitors has demonstrated that the development of allosteric and multi-mechanism inhibitors might lead the way to a more safer anticoagulant.