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School Of Pharmacy : Memo

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TTUHSC School of Pharmacy
Memo
To: John Zoidberg
From: Tuong Nguyen
Date: December 4, 2015

Re: Information on Pradaxa Dr. Zoidberg,
Thank you for your request for information regarding Pradaxa (dabigatran etexilate). As you stated, you have a patient named PF, who is planned to have hip arthroplasty in 2-4 weeks due to degenerative joint disease that is unresponsive to either physical therapy or simple pain relievers. Mr. PF is a 79 year-old male with hypertension and hyperlipidemia. His current medications include naproxen 220 mg po bid, tramadol 50 mg po tid, and enalapril 10 mg po qd. In addition, Mr. PF has the codeine allergy. Because of Mr. PF’s severe fear of giving himself shots, your concern is whether or not Mr. PF can have Pradaxa orally instead of enoxaparin 40mg subcutaneously for DVT prophylaxis and still receives the similar efficacy and safety.
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

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