Your scary medical video of the day (not graphic)
-
@george-k said in Your scary medical video of the day (not graphic):
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
@brenda said in Your scary medical video of the day (not graphic):
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
Same thing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904756/
Planning for elective surgery or invasive procedures should involve balancing the intervention-associated bleeding risk and thrombotic risk associated with anticoagulant interruption in each individual. A “safe” residual drug level of apixaban for surgery is presently unknown, and no test has been correlated with bleeding risk. As such, there is currently no known threshold at which apixaban patients’ bleeding risk are able to be comparable to non-apixaban treated patients [27].
In general, apixaban should be discontinued 2 to 3 days prior to elective surgery or invasive procedures [5], as outlined below and in Figure 2.
