By Scott A. Flanders, Sanjay Saint(eds.)
The first useful consultant for hospitalists at the use of anticoagulants in hospitalized patients
This edited quantity offers a finished evaluation of the very important subject of anticoagulation within the medical institution environment. Designed particularly to be used by way of hospital-based clinicians and linked hospital-based employees, this totally evidence-based ebook addresses the main familiar anticoagulant brokers, the newest advances in anticoagulation medicinal drugs, and first symptoms for his or her use at healing degrees.
This thorough, easy-to-use reference summarizes an important guidance and clinical literature on anticoagulation. It incorporates a cautious evaluate of the epidemiology and therapy of issues linked to anticoagulants. distinctive subject matters comprise transition of care and sensible innovations for constructing and imposing caliber development courses to reinforce the management and security of anticoagulants.
This concise source additionally covers:
The remedy and prevention of venous thromboembolism in clinical patients
Venous thromboembolism prophylaxis in surgical patients
Peri-operative administration of oral anticoagulants and antiplatelet agents
Prevention of cardioembolic stroke
Antithrombotics for ischemic stroke
Antithrombotic remedy for non-ST elevation acute coronary syndrome
Hemorrhagic problems of anticoagulants in hospitalized patients
Hospitalists and different contributors of the sufferer care staff will locate that Inpatient Anticoagulation solutions their questions with accountable and well timed information.Content:
Chapter 1 Pharmacology of Parenteral Anticoagulants (pages 1–24): Kathleen H. McCool and Daniel M. Witt
Chapter 2 Pharmacology of diet ok Antagonists (pages 25–46): Jaekyu Shin and Steven R. Kayser
Chapter three Antiplatelet drugs (pages 47–65): Michael Kornfeld and Joseph R. Munsayac
Chapter four more recent Oral Anticoagulants (pages 67–80): Taki Galanis and Geno J. Merli
Chapter five Prevention of Venous Thromboembolism in scientific sufferers (pages 81–106): Alex C. Spyropoulos and Charles E. Mahan
Chapter 6 Prevention of Venous Thromboembolism in Surgical sufferers (pages 107–136): Nancy Torres Finnerty and Franklin Michota
Chapter 7 therapy of Acute Venous Thromboembolism in Hospitalized sufferers (pages 137–160): Tracy Minichiello, Lauren Doctoroff and Elizabeth A. Farrell
Chapter eight Perioperative administration of Oral Anticoagulants and Antiplatelet brokers (pages 161–177): Ramiro Jervis and Andrew Dunn
Chapter nine Prevention of Cardioembolic Stroke (pages 179–203): Ali Mahajerin and Warren J. Manning
Chapter 10 Antithrombotics for Ischemic Stroke (pages 205–222): Fadi B. Nahab and Sakib Qureshi
Chapter eleven Antithrombotic remedy for Non?ST?Elevation Acute Coronary Syndrome (pages 223–240): David Lao and Andrew Boyle
Chapter 12 Parenteral Anticoagulants: specific issues in sufferers with persistent Kidney ailment and weight problems (pages 241–290): Sarah A. Spinler, Millie Rajyaguru, Julie okay. Atay and John Fanikos
Chapter thirteen Hemorrhagic issues of Anticoagulants in Hospitalized sufferers (pages 291–330): Allison Burnett, Jason Cohen and David A. Garcia
Chapter 14 Heparin?Induced Thrombocytopenia (pages 331–359): David Feinbloom and John Fani Srour
Chapter 15 Transitions in Care: Inpatient Anticoagulation (pages 361–375): Neil Gupta, Diane Sliwka and Margaret C. Fang
Chapter sixteen Optimizing Inpatient Anticoagulation: techniques for caliber development (pages 377–414): Greg Maynard, Ian Jenkins, Brian Clay, Michael Montazeri and Doug Humber
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Extra info for Inpatient Anticoagulation
PHARMACOKINETICS Warfarin is administered as a racemic drug. The S -enantiomer accounts for the anticoagulation effect of warfarin mainly because it is 3–5 times more potent than the R-enantiomer (Fig. 1) . Warfarin is well absorbed, and its blood concentration peaks within 4 h after oral administration. 14 L/kg). This small volume of distribution is due in part to warfarin’s high protein binding (99%). 2. Half-Lives of Vitamin K–Dependent Coagulation Factors and Anticoagulation Proteins Vitamin K–Dependent Factors Coagulation factors Factor II Factor VII Factor IX Factor X Anticoagulation proteins Protein C Protein S Half-life, h 60–72 4–6 24 48 8 30 warfarin because warfarin is a low-hepatic-extraction drug .
Some prefilled syringes have automatic safety mechanisms to prevent inadvertent needle sticks. Each product should be reviewed to determine the correct technique for deploying the needle guard. Injection sites should be alternated between right and left sides. In order to minimize bruising, the injection site should not be rubbed following drug administration. 9. CONCLUSION A sound understanding of the basic pharmacology of parenteral anticoagulants is necessary in order to facilitate the safe and effective clinical use of these agents.
Nonlinear relationship between INR and blood reserve of coagulation factors. 0. At an elevated INR, however, a small change in the reserve results in a significant INR change. 1. Factors Influencing Warfarin Dose Variability Age. Age is inversely related to warfarin dose. 001 . In addition, age is a predictor of warfarin dose in many warfarin-dosing algorithms [17,18]. Aging may change both the pharmacokinetics and pharmacodynamics of warfarin. Warfarin clearance may be decreased by 1% with each 1-year increment in age .