Recent Advances During Management Of Anti Coagulation

It is also important for the patient to be anticoagulanted as atrial fibrillation increases the risk of ischemic stroke (Ferguson et al. 2014). Fred was commenced on wafarin post operatively as well as intravenous heparin until he reached a therapeutic international normalised ration

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

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

Preventing errors relating to commonly used anticoagulants. (2008). Joint Commission perspectives. Joint Commission on Accreditation of Healthcare Organizations, 28(11), 13-15.

These TPAs are agents used to start hemostasis by converting plasminogen into plasmin, allowing fibrinolysis to occur (Alteplase). Hemostasis starts and it includes three processes combined that work together prevent or control blood loss (Alteplase). These three stages are vascular constriction, formation of the platelet plug and blood coagulation (Grossman, p.g.674). This means that Ronald is not a candidate for this medication since he is experiencing signs and symptoms of hemorrhagic stroke and this drug can make the bleed worsen due to clot dissolving mechanism. It is contraindicated to give a TPA to a patient experiencing an intracranial hemorrhage or active bleeding (Alteplase). Although he may not be able to have a TPA, he would be able to have medications that will try to help decrease his blood pressure and brain

3.) The founders of The Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines are:

Atrial fibrillation is the most frequent cardiac arrhythmia. There has always associated risk of clot formation and embolization that can lead to ischemic stroke. A large number of these ischemic events could be prevented by timely anticoagulation. Warfarin has been used for decades for this purpose, but there are many problems for the patients due to warfarin therapy like there is continuous need of INR monitoring, many food and drug interactions of the drug, late onset of action and risk of major bleeding. Anticoagulation with the Novel oral anticoagulants e.g. Dabigatran, rivaroxaban, apixaban, endoxaban led to similar or even lower rates of ischemic stroke and major bleeding compared to an adjusted dose of warfarin (INR 2-3) in patients

Vitamin E may enhance antiplatelet effects and anticoagulant therapy. Monitoring will need to be done on this patient since he is also taking warfarin and aspirin. ( cite)

Anticoagulant therapy will started according to facility protocol. This therapy will decrease the blood’s ability to clot, and help to prevent the formation of new clots. Anticoagulants used will be warfarin, heparin, or coumadin. In facility therapy will be initiated via IV push according to facility protocol, with continuous monitoring of patient condition.

For many year’s patients with atrial fibrillation have been treated with anticoagulants such as Warfarin to prevent strokes and embolisms. Unfortunately, Warfarin must be closely monitored and that is an irritant for some patients. In October 2010, the FDA approved a new generational anticoagulant drug called Dabigatran (Pradaxa). This alternate medication gives patients the benefit of no dietary restrictions since dabigatran is not affected by certain foods. Another benefit of taking dabigatran is a monthly blood test is not required to measure its effectiveness, so for this particular reason many patients switch from taking other anticoagulants to dabigatran (Talati & White, 2011). Since this medication does not require close monitoring, some wonder if is it truly a better option or can more harm than good come from taking it. While the benefits of using dabigatran have shown significant improvement over warfarin, there are still risks associated with using dabigatran.

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

The pharmacological intervention includes the use of low molecular weight heparin (LMWH) and low-dose unfractionated heparin (LDUH). A finding of the study suggests that there is a significant reduction of VTE (13%) using thrombo-prophylaxis than without using any thrombo-prophylaxis (27%) and the single use of LDUH decreases the case with 15% (McNamara, 2014, pp.645). Furthermore, the study elaborates the use of aspirin could be an intervention to minimize the VTE but there is a chance of gastrointestinal bleeding. Thus, aspirin and other antiplatelet drugs are less effective methods to reduce VTE. Moreover, the pharmacological method is not effective in certain case that is associated with bleeding disorder. Therefore, there is a need of non-pharmacological preventive

In a hospital setting, anticoagulants and antiplatelets are widely prescribed by physicians because of their greater benefits in changing the physiological homeostasis of the cardiovascular system. Anticoagulants and antiplatelets play a fundamental role in the treatment of cardiovascular diseases as they are very effective at counteracting the different symptoms cardiovascular diseases present.