New to Meducation?
Sign up
Already signed up? Log In

Category

Www.bmj
1
29

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
20

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
18

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
3
132

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Preview
2
109

Warfarin (coumadin) Pharmacology

Warfarin pharmacology. This is the best online medical lectures site, providing high quality medical and nursing lectures for students across the globe. Our ...  
YouTube
over 5 years ago
Preview
1
26

Sudden onset double vision

An 83 year old woman was admitted to the acute stroke unit with sudden onset double vision that had lasted for three hours. She had a medical history of monoclonal gammopathy of uncertain significance and atrial fibrillation, for which she was not receiving anticoagulation because of an adverse reaction to warfarin. She had no history of transient ischaemic attack or stroke. She had diplopia only when looking through her right. On examination she was unable to adduct her left eye, with nystagmus in her right eye when she attempted to do this. Her neurological examination was otherwise normal. Computed tomography of the head on admission was normal, as was magnetic resonance imaging of the head, which was requested the next day. Figure 1⇓ shows T2 weighted (A) and diffusion weighted (B) sequences at the level of the upper pons.  
bmj.com
over 5 years ago
Preview
1
17

Sudden onset double vision

An 83 year old woman was admitted to the acute stroke unit with sudden onset double vision that had lasted for three hours. She had a medical history of monoclonal gammopathy of uncertain significance and atrial fibrillation, for which she was not receiving anticoagulation because of an adverse reaction to warfarin. She had no history of transient ischaemic attack or stroke. She had diplopia only when looking through her right. On examination she was unable to adduct her left eye, with nystagmus in her right eye when she attempted to do this. Her neurological examination was otherwise normal. Computed tomography of the head on admission was normal, as was magnetic resonance imaging of the head, which was requested the next day. Figure 1⇓ shows T2 weighted (A) and diffusion weighted (B) sequences at the level of the upper pons.  
bmj.com
over 5 years ago
Preview
1
14

Sudden onset double vision

An 83 year old woman was admitted to the acute stroke unit with sudden onset double vision that had lasted for three hours. She had a medical history of monoclonal gammopathy of uncertain significance and atrial fibrillation, for which she was not receiving anticoagulation because of an adverse reaction to warfarin. She had no history of transient ischaemic attack or stroke. She had diplopia only when looking through her right. On examination she was unable to adduct her left eye, with nystagmus in her right eye when she attempted to do this. Her neurological examination was otherwise normal. Computed tomography of the head on admission was normal, as was magnetic resonance imaging of the head, which was requested the next day. Figure 1⇓ shows T2 weighted (A) and diffusion weighted (B) sequences at the level of the upper pons.  
bmj.com
over 5 years ago
Preview
1
18

Sudden onset double vision

An 83 year old woman was admitted to the acute stroke unit with sudden onset double vision that had lasted for three hours. She had a medical history of monoclonal gammopathy of uncertain significance and atrial fibrillation, for which she was not receiving anticoagulation because of an adverse reaction to warfarin. She had no history of transient ischaemic attack or stroke. She had diplopia only when looking through her right. On examination she was unable to adduct her left eye, with nystagmus in her right eye when she attempted to do this. Her neurological examination was otherwise normal. Computed tomography of the head on admission was normal, as was magnetic resonance imaging of the head, which was requested the next day. Figure 1⇓ shows T2 weighted (A) and diffusion weighted (B) sequences at the level of the upper pons.  
bmj.com
over 5 years ago
Preview
1
102

Warfarin (coumadin) Pharmacology

Warfarin pharmacology. This is the best online medical lectures site, providing high quality medical and nursing lectures for students across the globe. Our ...  
YouTube
about 5 years ago
Preview
1
113

Clotting Cascade

HEPARIN affects factor VIII in the INTRINSIC pathway and this is measured using PTT (partial thromboplastin time) WARFARIN affects the vitamin K dependent synthesis of some clotting factors (purple in the image), particularly factor VII in the EXTRINSIC pathway and this is measured using PT (prothombin time) or INR (International Normalized Ratio, which is derived from the PT)  
Sketchy Medicine
over 4 years ago
9
0
33

If warfarin indirectly inhibits Protein C and S causing a procoagulant state, how does it work in the long term despite that?

Given that it causes a paradoxical procoagulation state within the first 36 hours of initial administration due to the inhibition of Protein C and S, and therefore we give Heparin to counteract this process.. How does warfarin continue to be an anticoagulant after that period of time (after stopping heparin) without further risk of coagulation due to inhibition of protein c and s?  
Abdelrahman Mona
almost 7 years ago
11
0
19

Reversal of warfarin, effect of IV or oral vitamin K?

I know that you can use Vitamin K to reverse the effects of Warfarin and this will help normalise the INR. I have heard that IV Vitamin K makes the subsequent stabilisation of INR more difficult if Warfarin is recommenced, and that oral Vitamin K will mean that, if Warfarin is subsequently restarted, it will be stabilised more easily. Is this people's experience and does anyone know why this is the case or what the evidence is of this? Thanks.  
Sammy Watts
almost 7 years ago
Preview
0
11

High INR on warfarin

Clarify the warfarin dose that the patient is taking, and check for co-existing problems (such as liver disease or cancer), dietary changes, and intake of alcohol and other drugs that may increase risk of bleeding or affect international normalised ratio control  
feeds.bmj.com
over 4 years ago
Preview
0
19

High INR on warfarin

Clarify the warfarin dose that the patient is taking, and check for co-existing problems (such as liver disease or cancer), dietary changes, and intake of alcohol and other drugs that may increase risk of bleeding or affect international normalised ratio control  
feeds.bmj.com
over 4 years ago
Preview
0
12

Warfarin withdrawal in atrial fibrillation patients awaiting surgery dramatically ups stroke risk

We report from the 67th Annual Meeting of the American Academy of Neurology, where researchers have examined the risk of ischemic stroke among atrial fibrillation patients.  
medicalnewstoday.com
over 4 years ago
Preview
0
7

Patients taking warfarin should be able to self-monitor says NICE in new guidance

The National Institute for Health and Clinical Excellence (NICE) has published its diagnostics guidance on self-monitoring...  
medicalnewstoday.com
over 4 years ago
Preview
0
18

With Poor NOAC Adherence, Monitoring Seen as Partial Solution

Patients on new oral anticoagulants, as those on warfarin, need systems in place to ensure adherence, say researchers, who add that patient education and coagulation monitoring would be crucial.  
medscape.com
over 4 years ago
Preview
0
53

Anti-coagulant and Anti-platelet Reversal with intracerebral bleed

So you have a patient with intracranial bleeding or you have a high pre-ct suspicion of intracranial bleeding and they are taking coumadin, aspirin, or clopidogrel. Should you reverse them? If so, how?  
emcrit.org
over 4 years ago
Preview
0
11

FDA Approval: On-X Aortic Valves With Less Warfarin

Thousands of Americans with On-X Aortic Heart Valves may be able to reduce their regular blood-thinning medication regimen, thanks to an expanded...  
meddeviceonline.com
over 4 years ago