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https://www.readbyqxmd.com/read/29338845/protocolized-warfarin-reversal-with-4-factor-prothrombin-complex-concentrate-versus-3-factor-prothrombin-complex-concentrate-with-recombinant-factor-viia
#1
Cassie A Barton, Marissa Hom, Nathan B Johnson, Jon Case, Ran Ran, Martin Schreiber
INTRODUCTION: Life-threatening bleeding can complicate warfarin therapy. Rapid anticoagulant reversal via replacement of vitamin-K dependent clotting factors is essential for hemostasis. We compare two methods of rapid factor replacement for warfarin reversal. METHODS: A retrospective cohort study of warfarin-treated patients experiencing life-threatening bleeding who received a reversal protocol comprised of 4F PCC or 3F PCC and rFVIIa was performed. Demographic, clinical and anticoagulant reversal information, and all adverse events attributed to warfarin reversal were recorded...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29330715/case-series-analysis-of-new-zealand-reports-of-rapid-intense-potentiation-of-warfarin-by-roxithromycin
#2
Ruth L Savage, Michael V Tatley
INTRODUCTION: We undertook an analysis of all the reports to the New Zealand Centre for Adverse Reactions Monitoring of a roxithromycin/warfarin interaction after two recent reports described intense rapid warfarin potentiation. The interaction was first published in 1995. Cytochrome P450 3A4 inhibition has been the proposed mechanism but has limited biologic plausibility. There are suggestions that the clinical significance of the interaction may be increased by severe illness, polypharmacy, renal dysfunction, older age and increased warfarin sensitivity...
January 12, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29318005/precision-medicine-does-ethnicity-information-complement-genotype-based-prescribing-decisions
#3
REVIEW
Rashmi R Shah, Andrea Gaedigk
Inter-ethnic differences in drug response are all too well known. These are underpinned by a number of factors, including pharmacogenetic differences across various ethnic populations. Precision medicine relies on genotype-based prescribing decisions with the aim of maximizing efficacy and mitigating the risks. When there is no access to genotyping tests, ethnicity is frequently regarded as a proxy of the patient's probable genotype on the basis of overall population-based frequency of genetic variations in the ethnic group the patient belongs to, with some variations being ethnicity-specific...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29277691/genetic-polymorphisms-of-drug-metabolizing-cytochrome-p450-enzymes-in-cynomolgus-and-rhesus-monkeys-and-common-marmosets-in-preclinical-studies-for-humans
#4
REVIEW
Yasuhiro Uno, Shotaro Uehara, Hiroshi Yamazaki
Cynomolgus monkeys (Macaca fascicularis, Old World Monkeys) and common marmosets (Callithrix jacchus, New World Monkeys) have been widely, and expectedly, used as non-human primate models in drug development studies. Major drug-metabolizing cytochrome P450 (P450) enzymes information is now available that supports these primate species as animal models, and it is established that multiple forms of cynomolgus monkey and common marmoset P450 enzymes have generally similar substrate recognition functionality to human P450 enzymes...
December 22, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/29250278/the-nonvitamin-k-antagonist-oral-anticoagulants-and-atrial-fibrillation-challenges-and-considerations
#5
REVIEW
Anna Plitt, Sameer Bansilal
The nonvitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban are used for the reduction of the risk of stroke or systemic embolism (SEE) in patients with nonvalvular atrial fibrillation (NVAF). The purpose of this review is to highlight the safety and efficacy results of the pivotal NOAC clinical trials for use in NVAF, discuss some of the unique management challenges in the use of NOACs in special populations, summarize data on emerging and novel indications, and address potential future directions...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29248859/impact-of-age-comorbidity-and-polypharmacy-on-the-efficacy-and-safety-of-edoxaban-for-the-treatment-of-venous-thromboembolism-an-analysis-of-the-randomized-double-blind-hokusai-vte-trial
#6
Thomas Vanassche, Peter Verhamme, Philip S Wells, Annelise Segers, Walter Ageno, Marjolein P A Brekelmans, Cathy Z Chen, Alexander T Cohen, Michael A Grosso, Andria P Medina, Michele F Mercuri, Shannon M Winters, George Zhang, Jeffrey I Weitz, Gary E Raskob, Harry R Büller
BACKGROUND: Many patients with venous thromboembolism (VTE) are elderly, have multiple comorbidities and take several concomitant medications. Physicians may prefer warfarin over direct oral anticoagulants (DOACs) in such patients because comparative data are lacking. This analysis was designed to determine the effects of advanced age, comorbidities, and polypharmacy on the efficacy and safety of edoxaban and warfarin in patients with VTE. METHODS: Using data from the Hokusai-VTE study, we report rates of recurrent VTE and of clinically relevant bleeding by age category (<65, 65-75, and ≥75; <80 versus ≥80years), and by number of comorbidities (0, 1-2, >2) and concomitant medications (<3, 3-5, >5)...
December 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29244199/secondary-prevention-of-recurrent-venous-thromboembolism-after-initial-oral-anticoagulation-therapy-in-patients-with-unprovoked-venous-thromboembolism
#7
REVIEW
Lindsay Robertson, Su Ern Yeoh, Ahmad Ramli
BACKGROUND: Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy. OBJECTIVES: To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin, direct oral anticoagulants (DOACs)) for extended thromboprophylaxis in adults with a first unprovoked VTE, to prevent VTE recurrence after completion of an acceptable initial oral anticoagulant treatment period, as defined in individual studies...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29234073/identification-of-two-novel-genes-slc15a2-and-slco1b3-associated-with-maintenance-dose-variability-of-warfarin-in-a-chinese-population
#8
Liang-Liang Cai, Wen-Qing Huang, Zhi-Ying Su, Hui-Ming Ye, Lian-Sheng Wang, Yuan Wu, Zhong-Ying Zhang, Wei Zhang, Chi-Meng Tzeng
Warfarin is a commonly prescribed and effective oral anticoagulant. Genetic polymorphisms associated with warfarin metabolism and sensitivity have been implicated in the wide inter-individual dose variation that is observed. Several algorithms integrating patients' clinical characteristics and genetic polymorphism information have been explored to predict warfarin dose. However, most of these algorithms could explain only over half of the variation in a warfarin maintenance dose, suggesting that additional genetic factors may exist and need to be identified...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29199766/pentasaccharides-for-the-treatment-of-deep-vein-thrombosis
#9
REVIEW
Gustavo Ms Brandao, Daniela R Junqueira, Hamilton A Rollo, Marcone L Sobreira
BACKGROUND: Standard treatment of deep vein thrombosis (DVT) is based on antithrombotic therapy, initially with parenteral administration of unfractionated heparin or low molecular weight heparins (LMWH) for five to seven days, then subsequent long-term therapy with oral vitamin K antagonists (e.g. warfarin). Pentasaccharides are novel anticoagulants that may be favourable over standard therapy due to their predictable effect, no need for frequent monitoring or re-dosing, and few known drug interactions...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29198732/application-of-process-mapping-to-understand-integration-of-high-risk-medicine-care-bundles-within-community-pharmacy-practice
#10
Natalie M Weir, Rosemary Newham, Emma D Corcoran, Ashwag Ali Atallah Al-Gethami, Ali Mohammed Abd Alridha, Paul Bowie, Anne Watson, Marion Bennie
OBJECTIVE: The Scottish Patient Safety Programme - Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions...
November 21, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29196903/concurrent-use-of-prescription-drugs-and-herbal-medicinal-products-in-older-adults-a-systematic-review
#11
REVIEW
Taofikat B Agbabiaka, Barbara Wider, Leala K Watson, Claire Goodman
BACKGROUND: The use of herbal medicinal products (HMPs) is common among older adults; however, little is known about concurrent use with prescription drugs, as well as potential interactions associated with such combinations. OBJECTIVE: The aim of this systematic review was to identify and evaluate the literature on concurrent prescription and HMP use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. METHODS: Systematic searches were conducted in the MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane databases from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults ≥ 65 years of age...
December 1, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29192498/membrane-protein-structure-in-live-cells-methodology-for-studying-drug-interaction-by-mass-spectrometry-based-footprinting
#12
Guo-Min Shen, Shuang Li, Weidong Cui, Shixuan Liu, Yihu Yang, Michael L Gross, Weikai Li
Mass spectrometry (MS) based footprinting is an emerging approach to study protein structure. Because integral membrane proteins are difficult targets for conventional structural biology, we recently developed a MS footprinting method to probe membrane protein/drug interactions in live cells. This method can detect structural difference between apo and drug-bound states of membrane proteins, with the changes inferred from MS quantification of the cysteine modification pattern, generated by residue-specific chemical labeling...
December 1, 2017: Biochemistry
https://www.readbyqxmd.com/read/29189976/validation-of-knowledge-and-adherence-assessment-tools-among-patients-on-warfarin-therapy-in-a-saudi-hospital-anticoagulant-clinic
#13
Sireen Abdul Rahim Shilbayeh, Wejdan Ali Almutairi, Sarah Ahmed Alyahya, Nouf Hayef Alshammari, Eiad Shaheen, Alya Adam
Background Although it can result in serious complications due to its narrow therapeutic index, warfarin is widely used in the treatment and prevention of thromboembolic disorders. However, patients' adherence and knowledge are determinants of therapeutic success. Objective We sought to validate instruments to provide a reliable means of identifying gaps in patient understanding and nonadherence to inform targeted pharmacists' interventions to improve these measures. Methods A cross-sectional survey was conducted...
November 30, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29183961/oral-anticoagulants-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#14
REVIEW
José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Objective To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.Design Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources Medline, PreMedline, Embase, and The Cochrane Library.Eligibility criteria for selecting studies Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.Results 23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2...
November 28, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29181693/cost-effectiveness-analysis-of-patient-self-testing-therapy-of-oral-anticoagulation
#15
Sutat Kantito, Surasak Saokaew, Sukit Yamwong, Prin Vathesatogkit, Wisuit Katekao, Piyamitr Sritara, Nathorn Chaiyakunapruk
Patient Self-testing (PST) could be an option for present anticoagulation therapy monitoring, but current evidence on its cost-effectiveness is limited. This study aims to estimate the cost-effectiveness of PST to other different care approaches for anticoagulation therapy in Thailand, a low-to-middle income country (LMIC). A Markov model was used to compare lifetime costs and quality-adjusted life years (QALYs) accrued to patients receiving warfarin through PST or either anticoagulation clinic (AC) or usual care (UC)...
November 27, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29178968/cohort-specific-imputation-of-gene-expression-improves-prediction-of-warfarin-dose-for-african-americans
#16
Assaf Gottlieb, Roxana Daneshjou, Marianne DeGorter, Stephane Bourgeois, Peter J Svensson, Mia Wadelius, Panos Deloukas, Stephen B Montgomery, Russ B Altman
BACKGROUND: Genome-wide association studies are useful for discovering genotype-phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into "gene level" effects. METHODS: Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions...
November 24, 2017: Genome Medicine
https://www.readbyqxmd.com/read/29170877/oral-anticoagulant-dosing-administration-and-storage-a-cross-sectional-survey-of-canadian-health-care-providers
#17
Siavash Piran, Sam Schulman, Mohamed Panju, Menaka Pai
Direct oral anticoagulant (DOAC) use is increasing worldwide. However, if not taken or prescribed correctly, DOACs have serious side effects. It is crucial that healthcare providers (HCPs) offer patients accurate information and counselling around DOACs, to optimize safe and effective use. To assess knowledge around oral anticoagulant indication, dosing, storage, and administration, an electronic survey was distributed to HCPs across Canada from June to August 2017, with 18 questions on the practical use of oral anticoagulants...
November 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29156997/clinical-manifestations-and-outcomes-of-severe-warfarin-overanticoagulation-from-the-ewa-study
#18
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Aku Virta, K E Juhani Airaksinen
INTRODUCTION: Severe warfarin overanticoagulation is a risk factor for bleeding, but there is little information on its manifestations, prognosis and factors affecting the outcome. We describe the manifestations and clinical outcomes of severe warfarin overanticoagulation in a large group of patients with atrial fibrillation (AF). MATERIAL AND METHODS: All international normalized ratio (INR) samples (n = 961,431) in the Turku University Hospital region between 2003 and 2015 were screened...
November 23, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29155884/the-importance-of-mean-time-in-therapeutic-range-for-complication-rates-in-warfarin-therapy-of-patients-with-atrial-fibrillation-a-systematic-review-and-meta-regression-analysis
#19
Anne Sig Vestergaard, Flemming Skjøth, Torben Bjerregaard Larsen, Lars Holger Ehlers
BACKGROUND: \Anticoagulation is used for stroke prophylaxis in non-valvular atrial fibrillation, amongst other by use of the vitamin K antagonist, warfarin. Quality in warfarin therapy is often summarized by the time patients spend within the therapeutic range (percent time in therapeutic range, TTR). The correlation between TTR and the occurrence of complications during warfarin therapy has been established, but the influence of patient characteristics in that respect remains undetermined...
2017: PloS One
https://www.readbyqxmd.com/read/29137047/massive-neonatal-intracranial-hemorrhage-caused-by-bromadiolone-a-case-report
#20
Mingsheng Ma, Mengqi Zhang, Xiaoyan Tang, Zhenghong Li
RATIONALE: Bromadiolone, often called a super-warfarin, is a potent rodenticide with long half-life. Skin and mucosal bleeding is the most common clinical manifestations of its intoxication. Bromadiolone intoxications in adults and children have been reported, but this phenomenon is rarely seen in fetuses. This paper presents a case of neonate with massive intracranial hemorrhage mediated by bromadiolone intoxication, highlighting that the bromadiolone is potentially lethal to the fetus...
November 2017: Medicine (Baltimore)
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