Newly Approved Blood Thinner Problem

jgenesio

jgenesio

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Newly Approved Blood Thinner (Pradaxa™) May Increase Susceptibility to Some Viral Infections. – See report online at Infection Control Today.
 
I have never seen Pradaxa prescribed since I started working. It's all about Brilinta and Xeralto now
 
Chase said:
I have never seen Pradaxa prescribed since I started working. It's all about Brilinta and Xeralto now
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Excuse my ignorance. But say when someone hits their head the ER wants to know if they are on Coumadin or anything like that.

Would those 3 meds listed be something to look for and to tell the hospital?
 
Anjel said:
Excuse my ignorance. But say when someone hits their head the ER wants to know if they are on Coumadin or anything like that.

Would those 3 meds listed be something to look for and to tell the hospital?
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To simplify things, Pradaxa is similar to Coumadin (but not reversible by Vitamin K), and Effient is very similar to Plavix. Brilinta works in a similar mechanism to Aspirin, and Xarelto is a different beast altogether. It's a new class of drug that directly inhibits an enzyme of the clotting cascade.

All obviously have the potential to increase bleeding, so it is good to scan potential trauma pt.'s med lists for these and pass them on to the ED.
 
Sorry, don't know where I just pulled Effient from in that last post. Apparently I thought it was left out and should be included.
 
Anjel said:
Excuse my ignorance. But say when someone hits their head the ER wants to know if they are on Coumadin or anything like that.

Would those 3 meds listed be something to look for and to tell the hospital?
Click to expand...

There is an abundance of various drug classes that are "blood thinners", anticoagulants or antiplatelets. They all vary in their mechanism of action, half life, and reversibility. Some will make a clinically significant difference in traumatic bleeds and others will not.

Long story short; Yes, I would mention it but depending on the actual drug it might not make a difference in trauma care. Plus there are so many I would not expect most medics to be familiar with them all.

Just to name a few... Clopidogrel (Plavix), Prasugrel (Effient), Ticagrelor (Brilinta), Ticlopidine (Ticlid), Rivaroxaban (Xeralto), Apixaban (Eliquis), Dabigatran (Pradaxa), Warfarin (Coumadin), Acenocoumarol (Simtrom), etc, etc
 
It's good to know which ones the patient is on, but unfortunately with a lot of these newer ones there isn't a reversal agent like there is with warfarin.

That said I like the data so far on xarelto and with it's approval now for DVT/PE treatment in addition to afib I see it being used much more than pradaxa which I'm not a fan of.
 
Pradaxa has a strong propensity to cause GI tract bleeds from stomach to rectum and has no counter-agent.
 
Chase said:
There is an abundance of various drug classes that are "blood thinners", anticoagulants or antiplatelets. They all vary in their mechanism of action, half life, and reversibility. Some will make a clinically significant difference in traumatic bleeds and others will not.
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And then there are medications with "increased bleeding/bruising" as a side effect. Cymbalta comes immediately to mind, but I'm sure there are others. I know someone who was on Cymbalta and 81mg ASA a day, and was told to stop the ASA due to the thinning action of Cymbalta.
 
And alcohol with any of these is a no-no.
 
Especially Antabuse!
 
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