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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 approved in the United States for the prevention of stroke and systemic arterial thromboembolism in longanimouss with non-valvular atrial fibrillation. The approved do drugs of dabigatran (Pradaxa, Boehringer Ingelheim) is 150 mg parlay 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 treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), but it is non FDA approved for that indication. However, based on published data, it somewhattimes is apply off-label in patients with DVT and PE. The hematologist-oncologist may be called upon for assistance with anticoagulation management in the p atient on dabigatran who needs interruption of therapy for a medical medical exam procedure, such as colonoscopy or esophagogastroduodenoscopy (EGD), a minor or major surgical procedure, or dental work.

The point forward a procedure that a patient should take the fearless dose of dabigatran depends on several factors, including what type of procedure is delineate and how much bleeding is expected with it, whether the patient is at high 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 k idney. The remainder is excreted via the bil! e. The half-life of dabigatran primarily is determined by nephritic function (see Table). In most patients with normal renal function, dabigatrans anticoagulant effect is mostly gone in spite of appearance 1 to 2 days after 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 desire to get a full essay, order it on our website: OrderCustomPaper.com

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