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https://www.readbyqxmd.com/read/29326482/compounded-apixaban-suspensions-for-enteral-feeding-tubes
#1
Maria L Caraballo, Seda Donmez, Kobi Nathan, Fang Zhao
Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility...
July 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29322630/inter-laboratory-variability-for-the-measurement-of-direct-oral-anticoagulants-results-from-the-external-quality-assessment-scheme
#2
Armando Tripodi, Veena Chantarangkul, Cristina Legnani, Sophie Testa, Alberto Tosetto
BACKGROUND: Tests for direct oral anticoagulants (DOAC) are not widely available. The perception that they are difficult to be run and are subjected to large between-laboratory variation makes their implementation difficult. AIMS: We carried out proficiency-testing surveys for DOAC within the activity of the external quality-assessment scheme of the Italian Federation of Thrombosis Centers. DESIGN: Participants were provided with coded freeze-dried plasmas without or with graded concentrations of the three main DOAC and asked to measure PT, APTT, thrombin time and DOAC concentrations by dedicated tests...
January 10, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#3
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
January 10, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29321947/portal-vein-thrombosis-due-to-an-increase-in-dose-of-testosterone-in-a-young-man-with-klinefelter-syndrome
#4
Waseem Amjad, Salma Khatoon, Twara Tarasaria, Gulru Sharifova
Klinefelter syndrome (KS) is associated with increased incidence of thrombotic events. Hypofibrinolysis is associated with increased risk of thromboembolism. Although testosterone replacement therapy (TRT) inhibits the hypofibrinolysis, it can still cause thrombosis paradoxically due to increased dose and duration of use. Herein, we present a case of a young male diagnosed with KS who was taking testosterone. The dose was increased to boost the energy levels, and the patient presented with abdominal pain. Computed tomography (CT) of the abdomen showed extensive portal vein thrombosis...
November 6, 2017: Curēus
https://www.readbyqxmd.com/read/29320795/direct-oral-anticoagulants-in-end-stage-renal-disease
#5
Adi J Klil-Drori, Vicky Tagalakis
Patients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD...
January 10, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29319249/stroke-prevention-in-atrial-fibrillation-which-is-the-best-balanced-in-efficacy-and-safety-as-a-thromboprophylactic
#6
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29305143/bleeding-complications-after-use-of-novel-oral-anticoagulants-in-patients-undergoing-cardiac-surgery
#7
Kambiz Hassan, Nikolai Bayer, Friederike Schlingloff, Martin Oberhoffer, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
BACKGROUND: To analyze the results of open-heart surgery and bleeding complications after administration of novel oral anticoagulants (NOAC). METHODS: We investigated 81 consecutive patients (age: 74 [IQR 68, 78] years) who underwent open-heart operations at our institution between July 2014 and June 2016. All patients presented for surgery while on NOAC therapy: 37 had Rivaroxaban (45.7%), 35 Apixaban (43.2%) and 9 Dabigatran (11.1%). The calculated risk, using the European System for Cardiac Operative Risk Evaluation II, was 3...
January 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#8
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302288/direct-oral-anticoagulants-and-its-implications-in-dentistry-a-review-of-literature
#9
REVIEW
Neus Lanau, Javier Mareque, Lluis Giner, Michel Zabalza
Background: Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously...
November 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/29299007/apixaban-concentration-with-and-without-coadministration-of-carbamazepine-a-case-with-no-apparent-interaction
#10
Norelle Evanger, Artur Szkotak, Linda Stang, Tammy J Bungard
No abstract text is available yet for this article.
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29296829/safety-pharmacokinetics-and-reversal-of-apixaban-anticoagulation-with-andexanet-alfa
#11
Deborah Siegal, Genmin Lu, Janet M Leeds, Mark Karbarz, Janice Castillo, Vandana Mathur, Athiwat Hutchaleelaha, Uma Sinha, Michael Kitt, Matt McClure, Stanley J Hollenbach, John T Curnutte, Pamela B Conley, Mark Crowther
Direct factor Xa (FXa) inhibitors lack a specific reversal agent for emergencies such as major bleeding or urgent surgery. Andexanet alfa, a modified, catalytically inactive, recombinant human FXa derivative, reverses anticoagulant effect by binding and sequestering FXa inhibitors. This original report of safety and dose-finding, phase 1 and 2 randomized, double-blind, placebo-controlled studies, investigated various doses of andexanet in healthy volunteers. Phase 1 evaluated the safety and pharmacokinetics of andexanet (n = 24) or placebo (n = 8)...
September 26, 2017: Blood Advances
https://www.readbyqxmd.com/read/29295790/direct-oral-anticoagulants-an-update
#12
REVIEW
Ana Isabel Franco Moreno, Rosa María Martín Díaz, María José García Navarro
Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome...
December 30, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29285754/oral-anticoagulation-in-people-with-cancer-who-have-no-therapeutic-or-prophylactic-indication-for-anticoagulation
#13
REVIEW
Lara A Kahale, Maram B Hakoum, Ibrahim G Tsolakian, Charbel F Matar, Maddalena Barba, Victor E D Yosuico, Irene Terrenato, Francesca Sperati, Holger Schünemann, Elie A Akl
BACKGROUND: Oral anticoagulants may improve the survival of people with cancer through both an antitumor effect and antithrombotic effect, yet increase the risk of bleeding. OBJECTIVES: To evaluate the efficacy and safety of oral anticoagulants in ambulatory people with cancer undergoing chemotherapy, hormonal therapy, immunotherapy or radiotherapy, but otherwise have no standard therapeutic or prophylactic indication for anticoagulation. SEARCH METHODS: We conducted a comprehensive literature search in February 2016 that included a major electronic search of Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 1), MEDLINE (Ovid) and Embase (Ovid); handsearching of conference proceedings; checking of references of included studies; a search for ongoing studies; and using the 'related citation' feature in PubMed...
December 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29285431/acute-kidney-injury-aggravated-by-treatment-initiation-with-apixaban-another-twist-of-anticoagulant-related-nephropathy
#14
Sergey V Brodsky, Nilesh S Mhaskar, Sampath Thiruveedi, Rajnish Dhingra, Sharon C Reuben, Edward Calomeni, Iouri Ivanov, Anjali Satoskar, Jessica Hemminger, Gyongyi Nadasdy, Lee Hebert, Brad Rovin, Tibor Nadasdy
Anticoagulant-related nephropathy (ARN) was initially described in patients on warfarin (as warfarin-related nephropathy) and recently in those using dabigatran. Herein, we report clinical history and kidney biopsy findings in a patient on apixaban (Eliquis). Initiation of treatment with apixaban resulted in aggravation of preexisting mild acute kidney injury (AKI). A few days after apixaban therapy, the patient became oligoanuric, and kidney biopsy showed severe acute tubular necrosis with numerous occlusive red blood cell casts...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29278991/managing-nonoperable-intracranial-bleeding-associated-with-apixaban-a-series-of-2-cases
#15
Andrew C Faust, Dang M Tran, Catherine Lo, Sophia Lai, Lyndsay Sheperd, Mary Liu, Tina Denetclaw
OBJECTIVE: To report 2 cases of nonoperable intracranial bleeding associated with apixaban managed by 3-factor prothrombin complex concentrate (PCC3). CASE SUMMARIES: Case 1 presented with a 1.3-cm left parieto-occipital hemorrhage and a thin subdural hematoma (SDH) on the left tentorium of the brain about 6 hours after his last dose of apixaban. Case 2 presented with a 4-mm left parafalcine SDH with time of most recent apixaban dose unknown. The patients received 24...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29276922/-clinico-pharmacological-and-clinical-basis-of-multiplicity-of-intake-of-novel-oral-anticoagulants
#16
D A Sychev, A N Levanov, I V Tsomaya, I I Sinitsina, A V Vardanyan
In this review we present comparison of pharmacokinetics of novel oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban, and edoxaban, principles of selection of a regimen of their dosing for phase III clinical trials in patients with atrial fibrillation. Multiplicity of administration of NOAC depends on required level of anticoagulation, ability to maintain anticoagulation for 24 hours, relationship between minimal and maximal levels of equilibrium concentrations, efficacy and safety. Once a day administration of some drugs of this group is reasonable from positions of clinical pharmacology...
November 2017: Kardiologiia
https://www.readbyqxmd.com/read/29276599/rapid-resolution-of-left-ventricular-thrombus-with-apixaban-therapy
#17
Abeer Berry, Daniel Brancheau, Marcel Zughaib
It is a common medical practice to anticoagulate an asymptomatic left ventricular mural thrombus following an ST-elevation myocardial infarction using a vitamin K antagonist. Novel oral anticoagulants have not been studied extensively in this context, and therefore, no recommendations have been made for their use. A 67-year-old male physician with no significant medical history presented to the cardiology clinic complaining of shortness of breath that had been gradually worsening over a 2-week period and was found to have an anterior wall myocardial infarction with apical left ventricular thrombus that was treated with apixaban...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/29276013/outcome-of-secondary-stroke-prevention-in-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants
#18
Taizen Nakase, Junta Moroi, Tatsuya Ishikawa
BACKGROUND: Since non-vitamin K antagonist oral anticoagulants (NOACs) were released for clinical use, many studies have investigated its effectiveness in stroke prevention. In this study, to determine whether or not there is a difference in outcome in secondary stroke prevention between warfarin and NOACs, patients with embolic stroke with newly prescribed anticoagulants were prospectively analyzed. METHODS: Patients with acute ischemic stroke, who newly started anticoagulant therapy, were consecutively asked to participate in this study...
December 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29260237/-anticoagulation-in-geriatric-patients-with-atrial-fibrillation-with-what-and-for-whom-no-more
#19
REVIEW
P Bahrmann, M Christ
Based on established risk scores, such as the CHA2DS2-VASc score, the indications for oral anticoagulation are given for patients over 65 years old with atrial fibrillation and even more so for patients over 75 years old. Before beginning anticoagulation a geriatric assessment for evaluation of the cognitive ability, the activities of daily living and the risk of falling should be made because of the known complications of anticoagulation. Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with non-vitamin K antagonist oral anticoagulants (NOAC) to prevent ischemic stroke...
December 19, 2017: Herz
https://www.readbyqxmd.com/read/29250278/the-nonvitamin-k-antagonist-oral-anticoagulants-and-atrial-fibrillation-challenges-and-considerations
#20
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
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