Venous Tromoldmbolism

The evidence based practice process gives more evidence of young patients with few risk factors and no structural heart defect, the benefits of anticoagulation may be outweighed by the risks of haemorrhage (bleeding). High quality guidelines and the systematic searches used for the topic in this portfolio were beneficial. Use of a rigorous and transparent process in this portfolio for identifying, appraising and adopting/ adapting guidelines are crucial to help for the decision making. A major factor that stops the usage of the new drug is unfortunately, there are no specific antidotes to reverse the coagulant effects of the direct thrombin or factor Xa

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

Venous Thromboembolism (VTE) is a disease that embodies both pulmonary embolism (PE) and deep vein thrombosis (DVT). On the side of research, VTE is the most common preventable cause of hospital-associated mortality and is both the second most common medical complication and cause of excess length of hospital stay (LOS). Furthermore, with appropriate evidence-based prophylactic measures, the occurrence of hospital-associated VTE (HA-VTE) can be reduced by as much as seventy percent. Subsequently, there are approximately between 200,000 and 300,000 VTE-related deaths annually, which is greater than the yearly rate of mortality for breast cancer,

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.

Pulmonary embolism resulting from deep vein thrombosis is the most common preventable cause of hospital death (Maynard, 2015). Consequently, the Surgeon General has called to action to prevent deep vein thrombosis. Deep vein thrombosis in the healthcare setting can be reduced through

Venous thrombosis is a multifactorial disease. In the majority of thrombosis patients a risk factor is not detectable. Virchow's triad refers to three primary influences for thrombus formation, endothelial injury, stasis, turbulence or abnormal blood flow, and blood hypercoagulability (Kyrle, 2009). A shift in balance between procoagulant and anticoagulant of the endothelium is responsible for thrombotic state (Kyrle, 2009). Endothelial injury is the physical loss of endothelium leading to exposure of subendothelial extra-cellular matrix, adhesion of platelets, release of tissue factor, depletion of PGI2 and plasminogen activators (Kumar, 2010). Abnormal blood flow refers to turbulence that causes endothelial injury, which is a major influence

The main co-morbidities with the cohort were: hypertension (65, 85.5%), diabetes type 2 (36, 47.4%) , and HF (28, 36.8%). Stroke was evident in 18 cases (23.7%), transient ischemic attack-TIA (10, 13.2%), and myocardial infarction (MI) (8, 10.5%). The least reported morbidities were thrombo-embolism-TE (5, 56.6%), and pulmonary embolism-PE (2, 2.6%). There were (9, 11.8%) patients taking Clopidogrel concomitantly

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

As the proportions of the aging U.S. population increases, more people are susceptible to venous thromboembolism (VTE) that often contribute to prolonged hospitalization, health complications, disability, poor quality of life, and premature death. This increase in VTE-related deaths and health complications has threatened the health and the economy of the U.S. society. Health care professionals need to make a better decision in preventing VTE, especially with the rise of new oral anticoagulants. Therefore, this integrative review discusses the effectiveness of Rivaroxaban, a new oral anticoagulant, versus Enoxaparin, a standard therapy, in preventing the occurrence of VTE thus reducing the nation’s

Warfarin is a very common used drug worldwide. Warfarin is used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a heart attack, stroke, deep vein thrombosis or pulmonary embolism. Although warfarin is commonly used, its management is very challenging. First, it has a very narrow therapeutic index- increased anticoagulant effect puts the patients at a risk of bleeding, while decreased anticoagulant effect puts them at a risk of thromboembolic disorders such as heart attack and stroke. And second, the wide variation among patients in drug response. Therefore, it needs long time to determine the adequate dosage for each patient. Complications from inappropriate warfarin dosing are among the adverse events most frequently reported to the US

Rivaroxaban (Xarelto) was approved by the FDA for the treatment of acute deep vein thrombosis and pulmonary embolism.

The BRIDGE trial, conducted by Douketis and associates,1 was a randomized, multicenter, double-blind, placebo-controlled trial that questioned the need for anticoagulation bridging in patients with atrial fibrillation, who are undergoing an invasive procedure that requires interruption of warfarin therapy. The primary efficacy outcome was arterial thromboembolism, which includes stroke, transient ischemic attack, and systemic embolism, whereas the secondary efficacy outcomes were acute myocardial infarction, deep-vein thrombosis, pulmonary embolism, and death. The primary and secondary safety outcomes were major and minor bleeding, respectively. Patients eligible for this trial must have been 18 years or older, had chronic atrial fibrillation or flutter, been on warfarin therapy for at least 3 months, had an international normalized ratio (INR) of 2.0 to 3.0, were undergoing an elective invasive procedure that required discontinuation of warfarin therapy, and had at least one CHAD2 stroke risk

Anticoagulant treatment for deep-vein thrombosis aims to prevent pulmonary embolism and recurrent thrombosis and also to avoid excessive bleeding. In addition, both the effect of therapy on the patients’ well-being and the cost of therapy are factors to be weighed in determining the optimal treatment. It is current practice to treat acute venous thrombosis with intravenous standard (unfractionated) heparin for at least five days in a dose adjusted to lengthen the activated partial-thromboplastin time into a desired range. Oral anticoagulant therapy is started concomitantly and continued for at least three months. This approach is effective, but it suffers from the limitation that patients need to be admitted to the hospital, where intravenous

Introduction: Atrial fibrillation (AF) produces a five-fold increase in the risk of stroke, and the exclusion of the left atrial appendage (LAA), the main source of thrombi, is an interesting therapeutic option in patients with contraindications for oral anticoagulation.

According to the article “Anticoagulants: A Review of the Pharmacology, Dosing, and Complications” by Mohammed Alquwaizani, Leo Buckley, Christopher Adams, John Fanikos, anticoagulants persist as the primary strategy for preventing and treating thrombosis. Hemorrhage is a principal adverse event while using anticoagulant drugs.