The Pros And Cons Of Anticoagulants

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

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

Administering anticoagulants is a major problem in the healthcare field. According to Monagle, Studdert, and Newall (2012), “Heparin is one of the most commonly used drugs in tertiary pediatric centres […and] a plethora of fatal and non-fatal heparin-related errors [are] being reported ” (p. 1). A specific incident occurred in 2007 regarding a medication error that affected the two infant twin boys of Dennis and Kimberly Quaid. Shortly after birth, the twins developed a staph infection and were to be given an anticoagulant called hep-lock. According to Rick Shapiro with The Legal Examiner, “the nurses administered at least two doses of heparin”(Shapiro, 2010, p. 1). Heparin is a more potent medication than hep-lock. This mistake meant

The usage of anticoagulant therapy is one of the most common forms of medical intervention. The CHADS2 score is the simplest and most commonly used stroke- risk assessment tool since its implementation 2001. This scale is used to determine whether or not anticoagulation therapy is required for patients with episodic atrial fib. A higher CHADS2 score is directly related to a greater risk of stroke. The level of risk from a thrombotic event is determined by a score which is tallied by including five common stroke risk factors; congestive heart failure, hypertension, age, diabetes, and history of stroke. If a patient is positive for any of these risk factors they receive one point with the history of stroke getting 2 points (Camm et al, 2010).

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.

• Treating deep vein thrombosis (DVT): it’s a blood clot that develops deep in the vein especially in the leg. Such clots are also termed as venous thrombosis. DVT triggers pain and can result in severe complications like pulmonary embolism, hence the medication is given but one should take the right amount of the medication and avoid Heparin overdose and underdose

Bleeding is one of warfarins most serious and harmful effects as major and fatal bleeding can be experienced by patients. A meta analysis of 33 studies concluded “The clinical impact of anticoagulant-related major bleeding in patients with venous thromboembolism is considerable” therefore the effects of bleeding should be taken into account by health care professionals when choosing whether to prescribe warfarin to a patient or to continue anti-coagulant therapy using warfarin in individual patients. In addition to bleeding another complication of warfarin is its narrow therapeutic index which makes it difficult to ensure patients stay within the required anticoagulation range. An analysis of 6454 patients taking warfarin for atrial fibrillation

The PLATO (Platelet Inhibition and Patient Outcomes) study was a large head-to-head patient outcomes study of Brilinta versus Plavix. The study was conducted to determine whether Brilinta with aspirin was superior to Plavix with aspirin for prevention of vascular events and death in a broad population of patients presenting with an ACS. The PLATO trials, a randomized, double-blind, double-dummy, event-driven trial, studied 18,624 patients which were hospitalized for an ACS, with or without ST-segment elevation. Treatment for these patients included either primary PCI procedure or medical management. Of those patients participating, 11,289 had at least 1 intracoronary stent. Patients were randomly given either a loading dose of Brilinta 180 mg with a maintenance dose of 90 mg twice daily, or a loading dose of Plavix 300 mg with a maintenance dose of 75 mg daily. All patients received aspirin at a dose of 325 mg daily for up to 6 months and dosage was decreased thereafter. At 12 months, 176 cases of definite stent thrombosis had occurred. Brilinta, compared to Plavix, reduced definite stent thrombosis (71 versus 105). Additionally, 275 events of definite or probable stent thrombosis and 355 events of any stent thrombosis also were documented. Again, Brilinta decreased the occurrence in probable stent thrombosis (118

If the patient remains at risk for further embolus immobilization from a persistent source, long-term anticoagulant therapy is recommended to prevent further acute arterial ischemic episodes within the clients. so as far as nursing implications we will go over the nursing implications as they relate to your anticoagulant therapy as a whole but just making sure that the patient is adhering to their prescribed medications that they’re on also educating the patients on any of those medications that they're not familiar with. to talk about a arterial aneurysms or aneurysms. We’re going to look at the aneurysms of central arteries, an aneurysm is an outpouching or dilation of the arterial wall and it is a common problem that involves the aorta. over time the dilated aortic wall

This stagnant blood forms clots that break off and inter the circulation. Atrial Fibrillation is a factor in about 15% of Embolism stroke.The risk of a stroke from atrial fibrillation can be dramatically reduced with daily use of anticoagulant medication.

DAPT had to have long enough time after implanting the stent into arteries to prevent stent thrombosis.Premature discontinuation of anticoagulation therapy, also known as premature discontinuation of DAPT, means discontinuation of DAPT for less than three months for sirolimus-eluting stents (SES) and shorter than six months for paclitaxel-eluting stents (PES). The outcome of the premature discontinuation of DAPT can increase the risk of stent thrombosis, myocardial infarction, and death. Bare-metal stents (BMS) do not relate to blood clotting issues after stent implantation such as stent thrombosis. Therefore, it can be said that BMS do not need anti-clotting therapies. On the contrary, drug-eluting stents have been involved with late stent thrombosis. To prevent this issue, optimal conditions of several factors should be considered. Those factors can be stent position and expansion, the number of stents, stent size, stent design, patient and lesion, and premature discontinuation of antiplatelet medicines. Revascularization can be defined that produce the healthy blood circulation to a body part again under the situation carrying depletion of oxygen to an organ. The terminology, revascularization, is usually used by surgical

Thrombus formation, stabilisation and dissolution is process that requires a balance of procoagulant and anticoagulant processes. Coagulation is used to control haemorrhage from the vascular endothelium. There are four main steps in this process: initial vascular injury, primary hemostasis, secondary hemostasis and clot formation. The first step, initial vascular injury, begins when the vascular endothelium has become damaged or inflamed. Anticoagulants and fibrinolytic mechanisms are introduced to help preserve adequate blood flow. The injury then results in vasoconstriction. Smooth muscle contractions begin before myogenic spasms occur which is then followed by endothelial and platelet release of autacoid vasoconstrictive substances (endothelin

Patient 2 was a 65 year old female who had arrived with her blood test request form for a coagulation screen, which includes INR (prothrombin time), APTT (activated partial thromboplastin time) and fibrinogen. A prothrombin test measures how long it takes for blood to clot, or, coagulate. APTT is a screening test done which evaluates the function of a patient’s intrinsic clotting system, the factors of prothrombin and fibrinogen that are involved, as well as prekallikrein (PK) and high molecular weight kininogen (HK). Additionally, Patient 2’s heparin anticoagulant therapy needed to be monitored; heparin being an anticoagulant which is administered intravenously or by injection in order to treat blood clots. A single CITRATE tube of the colour light blue was used for the patient’s blood collection; this tube contains sodium citrate as an anticoagulant and is used for drawing blood for the purpose of coagulation studies.