Anticoagulant Therapy

Warfarin is used most often for long-term prophylaxis of thrombosis. “Specific indications are (1) prevention of venous thrombosis and associated pulmonary embolism, (2) prevention of thromboembolism in patients with prosthetic heart valves, and (3) prevention of thrombosis during atrial fibrillation.”(Lehne, 2010, p. 605). Warfarin is the oral anticoagulant of choice for these indications. The drug has also been used to reduce the risk of recurrent transient ischemic attacks (TIA) and recurrent myocardial infarction (MI).(Lehne, 2010).

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

It is important to understand the adverse complications of NSAIDS which includes increased mortality, morbidity and increased health care cost. Providers should discuss potential adverse effects of NSAIDS to patients and also review medication list as some patients may be taking multiple NSAIDS without understanding the adverse effects of NSAIDS and recognize patients at risk for developing adverse events. It is one of the most preventable causes for hospital admissions in the elderly. Patients taking NSAIDS are more likely to be hospitalized versus those not taking

Rates of major bleeding were significantly lower for apixaban when compared to warfarin.(Schwarz UI, Ritchie MD, Bradford Y, et al.

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

Platelets are not really cells in a way. As Marieb (2012) mentions,” They are fragments of bizarre multinucleate cells called megakaryocytes (meg″ah-kar′e-o-sītz), which pinch off thousands of anucleate platelet “pieces” that quickly seal themselves off from the surrounding fluids” (p. 344) The liver helps produce blood clotting factors. If it is not in working order then the person is not able to stop bleeding as easily as someone who has a properly working liver. There is a correction to help produce the proper amount of blood clotting factors and that is to take Vitamin K.

Other outcomes were myocardial infarction, ischemic stroke, systemic thrombosis, venous thrombosis in other areas of the body besides the legs, and even death. The patients underwent assessment either in the clinic or by telephone at days 30, 90, 180, 270, and 360. This study was consistent with other studies in the fact that the use of rivaroxaban reduced the risk of recurrent venous thromboembolism by about 70%. Rivaroxaban was found to be more effective than aspirin for the prevention of recurrent venous thromboembolism and was associated with a smaller risk of bleeding. The primary outcome occurred in 17 out of the 1,107 individuals who received 20 mg of rivaroxaban and in 13 out of the 1,127 individuals who received 10 mg of rivaroxaban. This was compared to 50 out of the 1,131 individuals who received aspirin once a day. Rates of bleeding were 0.5% in individuals who received 20 mg of rivaroxaban, 0.4% in individuals who received 10 mg of rivaroxaban, and 0.3% in individuals who received aspirin. For patients with venous thromboembolism who continued anticoagulation the risk of a repetitive event was lower with rivaroxaban at both 20 mg and 10 mg of treatment doses rather than with

when I asked if Patient X was satisfied with his treatment plan, he responded with a definitive

Adverse drug events include adverse drug reactions (ADRs); drug-drug interactions due to uncertainty about the benefits and harms of simultaneous treatment; drug-disease interactions due to potential risk of worsening one condition by treating a co-existing one; improper drug election, sub- and supra-therapeutic dosage, noncompliance/failure to receive drug, and wrong drug (10, 13-16). Older adults are at increased risk for developing adverse drug events due to multiple concurrent diseases and physiological changes that occur as part of the ageing process, particularly, in pharmacokinetics (reduced renal elimination) and pharmacodynamics (increased sensitivity to certain medications) affecting drug disposition (10).

Essentially the most recognized ones are coping with indigestion, again pains, muscle aches and headaches. You must even be conscious of the truth that if you mix this medication with alcohol, the side results can develop even worse, oftentimes even

Enoxaparin is a low molecular weight heparin used to prevent thrombosis, particularly post surgery. Enoxaparin binds to antithrombin III which is responsible for inhibiting coagulation by acting on factor Xa. Enoxaparin accelerates the activity of antithrombin III therefore preventing clot formation (McKenna & Lim, 2014 p766). When a blood vessel is damaged, platelets in circulating blood stick to the site of injury and release chemicals that attract more platelets causing aggregation. There are both intrinsic and extrinsic pathways causing thrombi to form to maintain a closed cardiovascular system (Hollar, 2017). Immobility increases risk of thrombus formation as the blood becomes stagnant with gravity and decreased

Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding

The pharmacokinetics and pharmacodynamics of many commonly used drugs vary significantly across all age groups. Adverse Drug Reactions are one of the major concerns in the elderly. Adverse drug reactions, especially those that may be preventable, are among the most serious concerns about medication use in elderly in clinical setting. The incidence of adverse drug reactions in patients more than 60 years old compared with younger patients (age less than 30 years) increased by two or threefold. The ageing process is associated with physiological and pathological changes. It then makes individuals at a higher risk of multiple morbidity and treatment-related complications. Predisposing factors to adverse drug reactions which have been noted including

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,

Therefore, having considered that aspirin might lead to us both positive and negative effects, we should use aspirin correctly and effectively. However, the effects of aspirin on cancer or other diseases were likely to appear when people take aspirin more than three years. Nevertheless, some benefits would still maintain after a long-term user stop taking aspirin (Brown, 2014). In the meantime, it is generally accepted that the excess bleeding is the major threat related with the usage of aspirin, and its fatality rate increased with age. As a consequence, in order to balance the benefits and harms through using aspirin, for one thing, doctors must provide the appropriate treatment plan and the best care to identify exactly the diseases that