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Interruption of dabigatran therapy at times of surgery, colonoscopy and other procedures HemOnc Today, November 25, 2011[Soft Break]Beth Walden, MA; Stephan Moll, MD Dabigatran is an oral anticoagulant - a synthetic thrombin inhibitor that is sanction in the United States for the prevention of stroke and systemic arterial thromboembolism in perseverings with non-valvular atrial fibrillation. The approved do drugs of dabigatran (Pradaxa, Boehringer Ingelheim) is 150 mg divalent daily for patients with a glomerular filtration rate of more than 30 mL/min, and 75 mg twice daily for patients with a GFR of 15 mL/min to 30 mL/min. It has been investigated for intercession of deep vein thrombosis (DVT) and pulmonary embolism (PE), but it is non FDA approved for that indication. However, based on published data, it approximatelytimes is apply off-label in patients with DVT and PE. The hematologist-oncologist may be called upon for assistance with anticoagulation managemen t in the patient on dabigatran who needs interruption of therapy for a medical health check procedure, such as colonoscopy or esophagogastroduodenoscopy (EGD), a minor or major surgical procedure, or dental work.

The point sooner a procedure that a patient should take the sunny dose of dabigatran depends on several factors, including what type of procedure is assign and how much bleeding is expected with it, whether the patient is at postgraduate or low risk for thrombosis while off anticoagulants for some period of time, and the patients nephritic function. About 80% of dabigatran is excreted unchanged via the kidney. The remainder is excreted via the bile. The half-life o f dabigatran primarily is determined by nep! hritic function (see Table). In most patients with normal renal function, dabigatrans anticoagulant effect is mostly gone in spite of appearance 1 to 2 days by and by the last dose has been taken, as the drug is excreted by the kidney relatively quickly. Typically, after trine half-lives, most of the drug (87.5%) is gone. Most surgeries with...If you motivation to get a full essay, order it on our website: OrderEssay.net

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