Warfarin Dosing

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).

Dosages of the drug vary from one extreme to another based upon the patients needs.

Anticoagulation therapy monitoring is another medication safety goal in which the FNP promotes safety by using education and routinely monitoring lab

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

A nurse should maintain doses administration as per repeated cycle of frequencies every 4 hours or 3 hours per day. Guidelines that facilitate the administration of time-critical

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

From 1997 to 2007 anticoagulants have been identified as one of the top five drug types associated with patient safety in the United States. There is a big concern with patient education and medication administration in the hospital. In the hospital common problems included lack of standardization for the naming, labeling, and packaging of the medications that cause confusion. Additionally, lack of communication during report from nurse to nurse, information regarding monitoring, dose and time is not well communicated causing high risk for thromboembolism. Although some patients carry their treatment home, majority of patients receive treatment at the hospital. From year 1997 to 2008 twenty deaths and injuries occurred due to misuse of anticoagulants and only two deaths or injuries were associated with long term use. For patient education the health care profession must emphasis the importance of understanding and labeling the right medication, especially for pediatric patients. Additionally, anticoagulation labs should be provided before and during treatment to reduce any complications.

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

They design the drug therapy protocol and indicate the appropriate dosage to use so that patients get the optimal outcome of the medication. Clinical assessments are vital to test the efficiency and the safety of an existing medication specifically through therapeutic drug monitoring. This practice is known to provide effective pharmacologic therapy though producing the maximum benefit of a drug which can remain longer period of time within the patients and have almost no toxicity that could cause harm to patients. This is why therapeutic drug monitoring in the field of pharmacy is essential enough to figure out an effective medication against a disease without any dangerous toxic actions involved to improve patients’ quality of life and hopefully find exceptional cures which is one of the pharmacists’

The aim of this PBL is to highlight the usefulness of warfarin as a drug, but also the level of attention the patient, and prescriber, needs to safely use the medication due to its sensitive nature with polypharmacy stemming from its narrow therapeutic window. It is necessary to not only the consider the patient’s part in taking antibiotics and alcohol whilst on warfarin, but also question why the general practitioner did not raise this issue when prescribing Mr Wesley’s antibiotics, especially given his long term record of warfarin use.

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

Although evidence has shown the benefit of genetic testing in Warfarin dosing it is not standard practice. There is however a benefit to genetic testing and the FDA has updated the drug labels with

In conclusion, pharmacists should be careful and remind patient on warfarin therapy the use of herbs and supplements which has the effect of anticoagulant during the counselling session. This is because the interactions may lead to increase bleeding. Recommend patient to consult her health care provider for further information for her concurrent use of supplements such as ginkgo biloba and warfarin medication. If doctor allowed her to take ginkgo together with warfarin, educate the patient to monitor any unwanted effects.

Anticoagulant and Anti Thrombolytic – It is used for Atrial Fibrillation (AF). It helps to prevent the ischemic stroke in AF patients (Shakib, 2010). While monitoring the sign and symptoms of hemorrhage and as well as INR and PT, Mrs. Audrey is more likely to commence a low molecular weight heparin. As such, empirical studies suggest that the rate of the venous thromboembolism is lowered with patient on heparin than those managed with warfarin (Colwell et al., 1999).

Enoxaparin is a highly acidic mucopolysaccharide. It is an anticoagulant drug that is used primarily for prophylaxis of deep vein thrombosis (DVT) or for patients that exhibit pulmonary embolism (PE) that have underwent specific surgery. Enoxaparin functions as a serine-type endopeptidase inhibitor and targets antithrombin-III. It binds to it and creates a vertex that irreversibly inactivates clotting factor Xa. Enoxaparin binding to antithrombin-III also accelerates the activity of antithrombin-III which is a serine protease inhibitor that modulates the activation of blood coagulation. Enoxaparin inhibits the production of prothrombin to thrombin. Antithrombin-III inhibits thrombin, factors Xa, IXa, and XIa, as well as matripatase-3/TMPRSS7. With the presence of enoxaparin its inhibitory activity is increased greatly. With the Xa being catalyzed by the attachment of enoxaparin, the translation of prothrombin to thrombin is decreased.