[PDF] Treatment Of Non Vitamin K Antagonist Oral Anticoagulants eBook
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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.
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.
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.
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.
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.
Clinical application of antithrombotic therapy in both arterial disease (acute coronary syndromes, acute MI, peripheral arterial disease, valvular heart disease, atrial fibrillation) and venous disease, (venous thromboembolic disease and pulmonary embolism). Results of major clinical trials and their implications for clinical practice.
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.
Anticoagulant drugs are among the most frequently prescribed drugs in everyday clinical practice. In the past decades, several new direct oral anticoagulants were developed that changed the anticoagulant therapy landscape considerably. This book provides an extensive overview of all the known anticoagulants that can be useful for studying different aspects of the haemostatic system or as a starting point for new drug development. It is also a valuable tool for clinicians providing a description of the mode of action and management of therapy for anticoagulant drugs used in everyday clinical practice in different clinical settings, including direct oral anticoagulants dabigatran, rivaroxaban, apixaban and edoxaban.
Showcasing the expertise of top-tier specialists who contributed to the newly released guidelines for the care of thrombosis in cancer patients, this exciting guide was written and edited by members of the American Society of Clinical Oncology panel, (ASCO), on the prevention and treatment of cancer-associated thrombosis, among others, and provides