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Anticoagulant Options For The Patient: New Versus Old

881 words - 4 pages

Beginning an anticoagulant therapy can be a scary and daunting task for any patient. Even more so, for the patient who is naive to the medications and ramifications if not taken properly. Having a complete understanding of both the new and old therapies is imperative. There are numerous circumstances that warrant anticoagulation therapy. This study focuses on the use of anticoagulants for preventing strokes in patients with atrial fibrillation, more specifically, the use of Warfarin versus Pradaxa. According to Coppens, Hart, and Eikelboom (2013), stroke related incidences in patients with atrial fibrillation rise drastically with age. Furthermore, the morbidity and mortality rates, post ...view middle of the document...

Vitamin K decreases the effectiveness of warfarin by increasing coagulation; therefore the average intake of these particular foods must remain relatively constant. In contrast, pradaxa does not require routine laboratory monitoring. The same dose is taken on a daily basis unless changed by the prescribing physician. There are no known dietary restrictions; however incompatibilities with some medications exist. This is a fairly common concern with numerous medications and the benefits should always outweigh the risks. “The simplicity of treatment with a new oral anticoagulant [pradaxa] makes them particularly attractive as an alternative” (Coppens et al., 2013, p.1479). On the other hand, less monitoring may be pradaxa's greatest disadvantage as the first indication of an overdose, serious bleeding, could be missed (Grave, 2011). Patients are usually unaware that they inadvertently overdosed until they become symptomatic and their condition rapidly declines. The availability of an antidote in these circumstances poses another concern for the patient.
In the unfortunate event that a patient overdoses on Pradaxa, suffers a major trauma while taking the medication, or has serious bleeding; there is no antidote or reversal agent available at this time. While other measures can be taken, this can be a life threatening situation. The ability to quickly reverse the effects of an anticoagulant will continue to influence its prevalence. In contrast, warfarin has a well-known and established antidote. For patients with a supra-therapeutic INR, Vitamin K is used to reverse the extreme anti-coagulation. “Despite its complexities, warfarin remains the most prescribed anti-coagulant worldwide” (Grave, 2012, p.30). Warfarin is not infallible, but knowing there are evidence based solutions available provides comfort and reassurance to the consumer....

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