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Related Concept Videos

Pharmacovigilance01:19

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Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
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Therapeutic Drug Monitoring: Affecting Factors01:29

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Therapeutic Drug Monitoring: Overview and Classification01:16

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Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

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Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
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Pulse rhythm01:30

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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[Monitoring of NOAC].

R B Zotz1, L Weißbach2

  • 1Institut für Laboratoriumsmedizin & Transfusionsmedizin, LBT Zotz/Klimas, Immermannstraße 65a, 40210, Düsseldorf, Deutschland. zotz@zotzklimas.de.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|January 14, 2017
PubMed
Summary
This summary is machine-generated.

Monitoring non-vitamin K antagonist oral anticoagulants (NOACs) is typically unnecessary but can benefit specific patient groups. Identifying these subgroups and appropriate measurement methods is key for effective use.

Keywords:
ApixabanDabigatranDrug monitoringFactor Xa inhibitorsRivaroxaban

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Area of Science:

  • Pharmacology
  • Clinical Chemistry
  • Internal Medicine

Background:

  • Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used anticoagulants.
  • Routine monitoring of NOACs is generally not required.
  • However, monitoring may be beneficial in select patient populations.

Purpose of the Study:

  • To identify patient subgroups who could benefit from NOAC monitoring.
  • To describe available methods for monitoring NOACs.
  • To outline which coagulation parameters are affected by NOACs.

Main Methods:

  • A systematic literature search was conducted using PubMed.
  • Search terms included NOAC, DOAC, rivaroxaban, dabigatran, apixaban, and monitoring-related terms.
  • Results were compiled and reviewed to synthesize findings.

Main Results:

  • Monitoring is most advantageous in emergency bleeding cases to assess drug activity.
  • It aids decisions regarding thrombolysis after stroke in NOAC patients.
  • Monitoring can identify compliance issues and inform periprocedural management.
  • Quantitative methods (diluted thrombin time for dabigatran, anti-factor Xa for rivaroxaban/apixaban) are recommended over qualitative ones.

Conclusions:

  • Specific patient subgroups can benefit from monitoring NOAC plasma concentrations.
  • Considerations before measurement include the objective, potential consequences (e.g., dose adjustment), and appropriate method selection.