Non Vitamin K Antagonist Oral Anticoagulants Clinical Use Real World Data And Reversal Of Anticoagulant Effect
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| Author | : Özcan Başaran |
| Publisher | : |
| Total Pages | : |
| Release | : 2016 |
| Genre | : Medicine |
| ISBN | : |
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and is associated with a higher risk of thromboembolic events. CHA2DS2VASc score enables identification of those patients with AF who will most benefit from anticoagulation therapy and low-risk patients with AF who do not need any antithrombotic therapy. Antithrombotic drugs especially oral anticoagulants (OACs) are the mainstay of therapy to prevent stroke in patients with AF. Although vitamin K antagonists (VKAs) were the only available drugs for decades, numerous non-vitamin K antagonist oral anticoagulants (NOACs) have been developed and marketed for stroke prevention in recent years. The risk of stroke was reported to decline up to 68 % with OAC therapy, associated with good anticoagulation control with VKAs, assessed by time in therapeutic range (TTR). In low TTR values, VKAs were found to be associated with severe complications, and a minimum TTR of 58 % should be achieved to expect a net benefit from being on OAC therapy. Narrow therapeutic index, drug-drug interactions, and the need for close monitoring are the main disadvantages of VKAs, and management of patients have dramatically improved after the introduction of NOACs. NOACs have a more predictable anticoagulant affect which allows a fixed-dose regimen. The efficacy and safety of NOACs have been shown not only in large randomized controlled clinical trials but also in observational studies. The main advantages of NOACS such as "fixed-dose regimen" and "no need for regular anticoagulant therapy monitoring" may also be the Achilles heel of the use of these agents. Fixed-dose regimen may not be appropriate for elderly, for patients with chronic kidney disease, and for patients using interacting drugs. Adherence to NOAC therapy is another concern as it may be as low as 50 % in the chronic use of cardiovascular drugs, especially if the drug has no apparent affect to the patient. Thus, appropriate use of OACs among non-valvular AF (NVAF) patients is essential for stroke prophylaxis. We intended to review the use of OAC therapy among (NVAF) patients.
| Author | : Ozcan Basaran |
| Publisher | : BoD – Books on Demand |
| Total Pages | : 152 |
| Release | : 2016-09-08 |
| Genre | : Medical |
| ISBN | : 9535126660 |
The available parenteral and oral anticoagulants have a large clinical use. Understanding biochemistry of anticoagulants may help to improve therapeutic strategies. Resistance to vitamin K antagonist drugs might be a problem for rodent populations. Patients who have thrombogenic risk factors should be anticoagulated. The need for cardiac implantable electronic devices is increasing, and there is a substantial number of patients who are on oral anticoagulant therapy. Prothrombin complex concentrate and other plasma concentrates are useful to deal with over-coagulated situations. The efficacy and safety of non-vitamin K antagonist oral anticoagulants have been proven in large phase III trials. The real-world data suggest even better outcomes with these agents compared to vitamin K antagonists.
| Author | : Eduard Shantsila |
| Publisher | : Springer |
| Total Pages | : 82 |
| Release | : 2015-12-21 |
| Genre | : Medical |
| ISBN | : 331925460X |
This book is an essential guide to the medical treatment of thrombosis and presents core principles of anticoagulant therapeutics as well as drug recommendations. Written by recognized experts in the field, this concise, accessible handbook provides a unique and valuable resource in the cardiovascular field, both for those currently in training, and for those already in clinical or research practice.
| Author | : Masaaki Uno |
| Publisher | : Springer |
| Total Pages | : 101 |
| Release | : 2016-10-31 |
| Genre | : Medical |
| ISBN | : 9811018782 |
This book describes new concepts and strategies for the clinical application of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke. Although vitamin K antagonists have traditionally been used for the prevention of stroke, there are some problems associated with their use, such as the risk of intracranial hemorrhage, the need for dietary restrictions, and individual variability. Recently, NOACs have been introduced as alternatives to traditional anticoagulants and are becoming an option for treating stroke patients around the globe. However, their use is not without risk. Each chapter describes the successful use of NOACs for stroke patients and discusses their future impact from various points of view. The book is primarily written for neurosurgeons and neurologists but is also of interest to cardiologists involved in stroke treatment.
| Author | : L. Poller |
| Publisher | : CRC Press |
| Total Pages | : 288 |
| Release | : 1996-08-02 |
| Genre | : Medical |
| ISBN | : 9780340552667 |
Warfarin and related drugs have been used for over half a century in prevention and treatment of thrombotic disorders. Only recently however has their clinical role been firmly established by randomised studies and their benefit/risk ratio improved by lower dose therapy with improvements in laboratory monitoring. 'Oral Anticoagulants' is the first comprehensive, practical survey of the subject available. An international team of recognised experts provide detailed coverage on the mode of action; clinical pharmodynamics; magnitude and sources of variability in individuals response to oral anticoagulant; methods of individualising dosing regimens; laboratory monitoring; and comparison between the different currently prescribed oral anticoagulants.
| Author | : |
| Publisher | : |
| Total Pages | : |
| Release | : 19?? |
| Genre | : |
| ISBN | : 9789535126676 |
| Author | : Jean Marie Connors |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 133 |
| Release | : 2016-09-16 |
| Genre | : Medical |
| ISBN | : 0323463150 |
This issue of Hematology/Oncology Clinics is devoted to New Anticoagulant and Antithrombotic Agents and will include articles such as: Development and Pharmacology; Post Orthopedic Joint Replacement Surgery VTE Prophylaxis; Use for Afib; Treatment of Acute VTE; Extended Treatment of VTW; Bleeding Risks: Use in Special Poplulations; Monitoring Anticoagulant Effect, and many more articles surrounding this important title.
| Author | : Joe F. Lau |
| Publisher | : Springer |
| Total Pages | : 464 |
| Release | : 2018-04-16 |
| Genre | : Medical |
| ISBN | : 3319737090 |
This book presents the latest evidence and guidelines supporting the use of anticoagulant therapy for various clinical scenarios. The field of anticoagulation therapy is evolving rapidly, particularly since the arrival and widespread adoption of direct oral anticoagulants. Organized in two parts, this book reviews the pharmacologic properties of various anticoagulants and details the clinical applications of anticoagulant therapy. Drugs such as warfarin and unfractionated heparin, as well as parenteral and direct oral anticoagulants are discussed in terms of their pharmacokinetics, drug-disease interactions, dosing strategies, and risk considerations. Clinical applications of anticoagulant therapy in disorders such as acute coronary syndromes, atrial fibrillation, and thrombophilia and in special populations such as pregnant women, the elderly, and in the patient with cancer are highlighted. Clinical vignettes, algorithms, clinical pearls, and self-assessment questions are integrated throughout the book. Featuring contributions from authorities in the field, Anticoagulation Therapy is an essential resource for cardiologists, vascular medicine specialists, hematologists, internists, and all other healthcare professionals who prescribe anticoagulants.
| Author | : |
| Publisher | : |
| Total Pages | : |
| Release | : 1983 |
| Genre | : |
| ISBN | : |
| Author | : Kathryn Kiser |
| Publisher | : Springer |
| Total Pages | : 293 |
| Release | : 2017-05-31 |
| Genre | : Medical |
| ISBN | : 3319546430 |
Given the amount and complexity of information surrounding the the target specific oral anticoagulants a lengthy didactic educational format has the potential to be overwhelming to the reader and difficult to translate and apply to direct patient care. The proposed book will educate clinicians utilizing a series of clinical cases to simultaneously develop the readers’ knowledge base, problem-solving skills, and practically apply their new knowledge to a variety of clinical situations. These will be short focused case presentations that provide critical information and pose questions to the reader at key points in the decision making process. The cases will be relevant to what clinicians will encounter not only on a daily basis, but also reflective of scenarios that clinicians will not encounter regularly, but that they will have to act upon (e.g. a bleeding patient, patient scheduled for elective or emergent procedure, patient with changing renal function, patient on drugs that have a plausible yet unstudied drug interaction with a target specific oral anticoagulant etc). Included in the case studies will be evidence-based discussions (with appropriate references) that provide immediate feedback on the different treatment alternatives that were offered. The case studies will be designed to instruct the reader how to select and effectively utilize the most appropriate agent for a given clinical scenario. They will focus on key features of the target specific oral anticoagulants, what they have in common, how they are unique from each other, as well as illustrating the clinical decision process one should take when selecting an agent or managing a patient already receiving one of the target specific oral agents.
