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24

Safety of new oral anticoagulants

Two linked papers (doi:10.1136/bmj.h1857, doi:10.1136/bmj.h1585) report additional evidence on the risks of gastrointestinal bleeding among patients taking the novel oral anticoagulants dabigatran and rivaroxaban.1 2 From a database of more than 100 million US adults, Abraham and colleagues identified almost 220 000 new users of dabigatran, rivaroxaban, or warfarin between November 2010 and September 2013.1 In their comparison of propensity score matched patients, the risk of gastrointestinal bleeding increased significantly with age for both new oral anticoagulants, relative to warfarin. By age 75, the risk of gastrointestinal bleeding associated with rivaroxaban exceeded that with warfarin, for patients with or without atrial fibrillation. Among patients taking dabigatran, the association between older age and higher risk was confined to those with atrial fibrillation, although the data included very few patients without atrial fibrillation taking this drug.  
feeds.bmj.com
almost 5 years ago
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0
15

Safety of new oral anticoagulants

Two linked papers (doi:10.1136/bmj.h1857, doi:10.1136/bmj.h1585) report additional evidence on the risks of gastrointestinal bleeding among patients taking the novel oral anticoagulants dabigatran and rivaroxaban.1 2 From a database of more than 100 million US adults, Abraham and colleagues identified almost 220 000 new users of dabigatran, rivaroxaban, or warfarin between November 2010 and September 2013.1 In their comparison of propensity score matched patients, the risk of gastrointestinal bleeding increased significantly with age for both new oral anticoagulants, relative to warfarin. By age 75, the risk of gastrointestinal bleeding associated with rivaroxaban exceeded that with warfarin, for patients with or without atrial fibrillation. Among patients taking dabigatran, the association between older age and higher risk was confined to those with atrial fibrillation, although the data included very few patients without atrial fibrillation taking this drug.  
feeds.bmj.com
almost 5 years ago
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0
17

Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin: population based cohort study

Objective To determine the real world risk of gastrointestinal bleeding associated with the use of the novel oral anticoagulants dabigatran and rivaroxaban compared with warfarin.  
feeds.bmj.com
almost 5 years ago
Preview
0
13

Safety of new oral anticoagulants

Two linked papers (doi:10.1136/bmj.h1857, doi:10.1136/bmj.h1585) report additional evidence on the risks of gastrointestinal bleeding among patients taking the novel oral anticoagulants dabigatran and rivaroxaban.1 2 From a database of more than 100 million US adults, Abraham and colleagues identified almost 220 000 new users of dabigatran, rivaroxaban, or warfarin between November 2010 and September 2013.1 In their comparison of propensity score matched patients, the risk of gastrointestinal bleeding increased significantly with age for both new oral anticoagulants, relative to warfarin. By age 75, the risk of gastrointestinal bleeding associated with rivaroxaban exceeded that with warfarin, for patients with or without atrial fibrillation. Among patients taking dabigatran, the association between older age and higher risk was confined to those with atrial fibrillation, although the data included very few patients without atrial fibrillation taking this drug.  
feeds.bmj.com
almost 5 years ago
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2
40

Risk of GI bleeding associated with oral anticoagulants

Determining the real world safety of dabigatran or rivaroxaban compared with warfarin in terms of GI bleeding.  
bmj.com
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
almost 5 years ago
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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
about 5 years ago
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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
over 5 years ago
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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
almost 6 years ago
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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
almost 6 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
almost 6 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
almost 6 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
almost 6 years ago