Tag Archives: anticoagulation

Pharmacy & Therapeutics Newsletter 16.1

Headlines from the February issue of the P&T newsletter.

  • VTE Recurrence
  • Neonatal Preparation and Administration
  • Anti-Infective Medications Limited to the Order by an ID Specialist
  • Amphotericin B Deoxycholate added to the automatic substitution list
  • Injectable Iron Products for Use in the Ambulatory Clinic
  • IdaruCIZUMAB (PRDXBIND) added to the formulary
  • Reduction in Lidocaine Products

PT Newsletter 16.1 11.19.15PT

Pharmacy & Therapeutics Newsletter

PT Newsletter 15.6 091715PT

Pharmacy & Therapeutics Newsletter 15.5

PT Newsletter 15.5 062515PT

Pharmacy & Therapeutics Newsletter 15.2

PT Newsletter 15.2 112014PT

Discontinuation of Anticoagulants Prior to Surgery

Anticoagulants. Discontinuation Prior to Surgery 042915

Newer Anticoagulants

Newer Anticoagulants 0115

Pharmacy & Therapeutics Newsletter 15.4

Below is the P&T Newsletter as approved April 2015

PT Newsletter 15.4 042315PT

Pharmacy & Therapeutics Newsletter 15.3

Below is the P&T Newsletter as approved by Committee February 2015

PT Newsletter 15.3 022515PT

Outpatient Treatment of Deep Vein Thrombosis

At the June 26th 2014 Pharmacy and Therapeutics Committee meeting, discussion ensued with the Cardiologist and Hematologist members of the committee regarding the treatment of Deep Vein Thrombosis (DVT) on an outpatient basis. This concept is not new, and is reviewed in the 2012 CHEST Antithrombotic Therapy and Prevention of Thrombosis 9th ed. Guidelines, UpToDate and other references. The issue is that we occasionally find patients who have no other reason to be hospitalized except that they are waiting for their INR to become therapeutic. As referenced, options for outpatient treatment include bridging with Low Molecular Weight Heparin (LMWH) until the INR becomes therapeutic. Additionally, section 5.5 of the Chest 2012 guidelines recommends early discharge over standard discharge for patients with low risk PE whose home circumstances are adequate after five inpatient days.

There are four criteria that may be used to help identify patients who are NOT candidates for outpatient treatment:

  • Presence of massive DVT (eg, iliofemoral DVT)
  • Presence of symptomatic pulmonary embolism
  • High risk of bleeding with anticoagulant therapy
  • Presence of comorbid conditions or other factors that warrant in-hospital care

While initial treatment is recommended at home over hospital, this recommendation is conditional on the adequacy of home circumstances. Our intent is to evaluate a pathway at the September Pharmacy and Therapeutics Committee meeting that will aid physicians in the decision process. If your patient does not meet the criteria to remain in the hospital, we urge you to consider outpatient bridging therapy with LMWH and utilizing the Anticoagulation Clinic at Centegra.

Oral anticoagulants – a summary

Attached is a summary on the dosing, conversion, discontinuation and reversal for dabigatran (Pradaxa), apixaban (Eliquis) and rivaroxaban (Xaralto). This can be printed for personal use.

Please click on the link below for information on newer oral anticoagulants.

Newer Oral Anticoagulants