A New Generational Anticoagulant Drug

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

Stroke was defined as the sudden onset of a focal neurologic deficit in a location associated with the area of a major cerebral artery. The primary safety outcome was major hemorrhage and was defined as a reduction in the hemoglobin level of at least 20 g/L, transfusion of at least 2 units of blood, or symptomatic bleeding in a critical organ or area. Results were calculated using the Cox proportional-hazards modeling. Systolic embolism or stroke occurred in 199 patients receiving warfarin, 182 patients receiving 110 mg of dabigatran twice daily, and in 134 patients receiving dabigatran 150 mg twice daily. Major bleeding events occurred in 3.36% of participants per year with warfarin, 2.71% per year in patients that received 110 mg of dabigatran, and 3.11% per year in those receiving 150 mg of dabigatran. From calculated data, results revealed that dabigatran administered at a dose of 110 mg twice daily was non-inferior to that of warfarin. Lower rates of stroke were associated with dabigatran administered at a dose of 150 mg twice daily compared with that of warfarin. For safety, it was concluded that the risk of bleeding was lowest with dabigatran 110mg twice daily, and was similar between dabigatran 150 mg twice daily and

The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy

There are many people that suffer from venous thromboembolism. Venous thromboembolism includes both deep vein thrombosis and pulmonary embolism. This is the third most common cause of vascular death after a myocardial infarction, also known as a heart attack, and stroke. This article examines the possibility of either full or low intensity anticoagulation therapy versus aspirin. This was a randomized study that consisted of 3,396 individuals who have venous thromboembolism. These individuals either received rivaroxaban, which is an anticoagulant, or 100 mg of aspirin once a day. The individuals in this study completed 6-12 months of anticoagulation therapy and were eligible for inclusion in the study if they were 18 years of age or older. The

When one begins to discuss issues that arise with an intrinsic organ, things get serious. Unfortunately, vital organs like the heart and liver that are causing problems can’t be removed like the appendix or the kidney and “cure” people of issues such as Appendicitis or constant dealings with gallstones. This is true when things begin to go awry within the heart and conditions begin to arise. Atrial Fibrillation (A-fib) is the most common type of arrhythmia, or issue with the heart rate or rhythm. Though A-fib is not a condition that is life-threatening, depending on the severity and lack of treatment, this condition leads to more serious issues like heart disease, and even heart attacks and strokes, which are usually what end up being the cause of death in individuals diagnosed with the condition. Because of A-fib leading to other more detrimental problems, such as the ones listed above, it is difficult to identify and pinpoint if someone has it or had it, which is why it is known as one of the contributors to the “silent killer,” also known as the heart attack. In this paper, gaining a deeper understanding of Atrial Fibrillation will be accomplished through the exploration of: causes, diagnosis, symptoms and treatment, the variation of types, what all is affected within the body as a result, what happens physically, and what occurs at the cellular level when diagnosed with this disorder. All in all, Atrial Fibrillation should be taken seriously and further research is

This report is an analysis of an anonymous patient’s medications and how they relate to his health issues. Please note that the patient will be referred to as patient Afib in order to protect his privacy. Patient Afib is a 58 year old male with a recent onset of atrial fibrillation (AF) that has been cured using ablation and antiarrhythmic medications. This report discusses how physicians treated patient Afib’s AF, the medications patient Afib is currently taking and their mechanism of action, and how these medications relate to the patient’s disease. Medications discussed in this analysis include Proair HFA, Multaq, Toprol XL, and Coumadin. Proair HFA, a rescue inhaler used to treat asthma, was prescribed to patient Afib in order to determine if AF or underlying asthma caused his shortness of breath. Multaq is an antiarrhythmic drug used to keep patient Afib in a normal sinus rhythm. Toprol XL is a medication used in the treatment of hypertension that also exhibits rate controlling properties which prove beneficial for patient Afib. Coumadin, an anticoagulant, is used to reduce the risk of stroke for patient Afib should his AF ever spontaneously return without his knowledge. Patient Afib does not like the regime of pills he is required to take but understands their necessity.

The main concerns regarding treating a patient with AF are rhythm control, rate control, and anticoagulation (Zak, 2010). For patient X, he was started on Metoprolol (beta blocker), Amiodarone (anti-dysrhythmic) and Warfarin (anticoagulation). Due to Warfarin’s ability to alter the INR of the blood, it is imperative to monitor the INR frequently to ensure that the level is therapeutic (Shea and Sears, 2008). Patient X had a full time job though making minimum wage. He was unable to take time off of work to get his blood drawn monthly for INR levels at his doctor’s office. This would result in sub therapeutic levels of anticoagulation and therefore noncompliance. He suffered a pulmonary embolus from the sub therapeutic anticoagulation and was hospitalized. After speaking with his cardiologist regarding other means of anticoagulation, the decision was made to change his medication from Warfarin to Pradaxa, an anticoagulant of a different

Administering anticoagulants is a major problem in the healthcare field. According to Monagle, Studdert, and Newall (2012), “Heparin is one of the most commonly used drugs in tertiary pediatric centres […and] a plethora of fatal and non-fatal heparin-related errors [are] being reported ” (p. 1). A specific incident occurred in 2007 regarding a medication error that affected the two infant twin boys of Dennis and Kimberly Quaid. Shortly after birth, the twins developed a staph infection and were to be given an anticoagulant called hep-lock. According to Rick Shapiro with The Legal Examiner, “the nurses administered at least two doses of heparin”(Shapiro, 2010, p. 1). Heparin is a more potent medication than hep-lock. This mistake meant

The dabigatran etexilate (DE) is a prodrug that directly competes for the active site of thrombin.1 This direct inhibition inactivates both fibrin-bound and free form of thrombin. Because of its rapid onset and offset of action, there is no need for the initial parenteral anticoagulant treatment in patients with acute thrombosis.1 On the other hand, the enoxaparin indirectly inhibits factor Xa.2 It has a shorter duration of action (12h vs 24h) and a shorter half-life (4.5-7h vs 12-14h) in comparison to DE. The DE and the enoxaparin have no interaction with diet and alcohol. There is no routine monitoring required

Atrial Fibrillation is one of the leading causes of death across the globe. (1) AF increases an individual’s risk of stroke by 4 to 6 times on average. (2)(3) The risk increases with age, in people older than 80 years old; AF is the straight cause of 1 in 4 strokes. (3) Even though Atrial Fibrillation can be considered a mild arrhythmia; it is still associated with serious morbidity and mortality. (4)(5) First, it raises the risk of having thromboembolism and stroke, due to blood stasis in the left atrium. Stroke is commonly caused by a thrombus or clot. In patients with AF, the thrombus or clot is usually comes from the left atrial appendage (a small sac in the left upper chamber of the heart). Because stroke in AF patients may be particularly distressing, it is quite important to identify patients who are possibly at high risk before it occurs to them. Second, the irregularly irregular heart beat can cause symptoms palpitations, shortness of breath, anxiety and reduced exercise tolerance in the patient, so it requires medical consideration. Third, Atrial Fibrillation causes a lot of cardiac and hemodynamic changes including decreased myocardial systolic function and cardiomyopathy caused by tachycardia. (6)(7) Sometimes AF is identified only with the onset of a stroke or a transient ischemic attack (TIA or "mini-stroke"). (8) Whether if it is asymptomatic or symptomatic, AF is a progressive disease, worsening with time and it is accounting for

Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications. Arch Intern Med. 1995; 155:469-73.

There was total of 76 patients with AF receiving Dabigatran during the study period. The mean age was 67.9 ±1.5 years (range 29 - 98 years), males (52.6%, 66.3 ±1.7 years), and females (47.4%, 69.6 ±1.1years). The age group stratifications revealed the highest age group was those between 61 to 80 years (60.5%). The majority (73.7%) was ≤75 years, [Table 1]. 76.3% used Dabigatran 150 mg. The mean CHA2DS2, CHA2DS2-VASc, HAS-BLED score were 2.38 ±1.46, 3.54 ±1.82, and 3.46 ±1.205, respectively, [Table 2].

Atrial fibrillation is the most commonly encountered arrhythmia (abnormal heart rhythm) in the United States, diagnosed in approximately 1% of the population or 2.5 million people (Nottingham, 2010). Atrial fibrillation has always been of interest during this author’s healthcare career. It is always out there, insidiously hiding, causes a multitude of symptoms and problems. This author remembers puzzling over the presentation of atrial fibrillation and it’s management. Identification is always the first challenge. Banner and Lauck (2013) cite Falk (2001) acknowledging the wide presentation of symptoms from asymptomatic to life threatening. Patient specific options can be confusing and challenging to navigate. Treatment algorithms include pharmacology, electrophysiological interventions, and surgery (Berry, Padgett, & Holton, 2015). This author believes, given the prevalence and consequences of mismanagement, the study of relevant evidence based practice in the treatment of atrial fibrillation is a worthy concentration. For many patients, nurses are the first point of contact in the healthcare system. This demands nursing leadership in the areas of identification, treatment and education for atrial fibrillation.

This stagnant blood forms clots that break off and inter the circulation. Atrial Fibrillation is a factor in about 15% of Embolism stroke.The risk of a stroke from atrial fibrillation can be dramatically reduced with daily use of anticoagulant medication.

There are three types of atrial fibrillation. The first type is paroxysmal atrial fibrillation. It will occur at random time and stop by its own. This type of AF would normally stop within one week and it does not require any treatment. It will normally cause the most symptoms in people who has it as it is so unpredictable and