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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 approve in the United States for the prevention of stroke and systemic arterial thromboembolism in patient ofs with non-valvular atrial fibrillation. The approved do drugs of dabigatran (Pradaxa, Boehringer Ingelheim) is 150 mg range 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 interposition of deep vein thrombosis (DVT) and pulmonary embolism (PE), but it is non FDA approved for that indication. However, based on published data, it more or lesstimes is apply off-label in patients with DVT and PE. The hematologist-oncologist may be called upon for assistance with anticoagulation management 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 before a procedure that a patient should take the die hard dose of dabigatran depends on several factors, including what type of procedure is have in mind 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 of dabigatran primarily is determined by renal function (see Table). In most patients with normal renal function, dabigatrans anticoagulant effect is mostly gone in spite of appearance 1 to 2 days afterwards the last dose has been taken, as the drug is excreted by the kidney comparatively q uickly. Typically, after trine half-lives, ! most of the drug (87.5%) is gone. Most surgeries with...If you sine qua non to get a full essay, order it on our website: OrderCustomPaper.com

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