0       0

AMDA Long Term Care Medicine - 2012


B12 - Anti-Coagulation for A-fib in the Long Term Care Setting: Alternatives to Coumadin


Mar 9, 2012 11:00am ‐ Mar 9, 2012 12:00pm

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of clinical 1.0 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Coumadin is a high risk medication with a low therapeutic threshold impacted by many medications. Given that most long term care residents receive multiple medications, a variable diet and caloric intake, it is not surprising that maintaining therapeutic INR's is a challenge. Direct thrombin inhibitors have been introduced with the potential to be as effective as Coumadin, minimize drug interactions and possibly reduce overall risks. This session will provide an overview of this class of medications, clinical use and side- effect profile. The presenter will discuss his efforts to reduce Coumadin use in one long term care facility by switching to the thrombin inhibitors.

Learning Objectives(s):

  • Describe how direct thrombin inhibitors impact the clotting cascade.
  • Discuss the studies demonstrating effectiveness of thrombin inhibitors in clinical use.
  • Explain the rational of using plavix for selected patients in a-fib.


Speakers(s):
Jeffrey B. Burl, MD, CMD

Disclosure(s):
Jeffrey B. Burl, MD, CMD has no financial disclosures to report.

References(s):
Turpie AG, New oral anticoagulants in atrial fibrillation. Eur Heart J 2008;29:155 Becker RC,Next Generation antithrombin therapies,J Invasive Cardiol 2009: 21 Mannucci PM et al, Old and new antcoagulant drugs: a minreview. Ann Med 2011; 43:116 Ezekowitz MD etal, Dabigatran with or without concomitant aspirin compared with warfarin alone in patients with nonvavular atrial fibrillation. AmJ Cardiol 2007;100:1419 Schulman S et al, Dabigatran vesus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 2009;361:2342 Garcia D etal, The new oral anticoagulants. Blood 2010;115:15 Freeman JV et al, Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrail fibrillation, Ann Int Med 2011; 154:1 Freeman JV et al, Dabigatran compared with warfarin for stroke prevention in atrial fibrillation. Ann Int Med 2011; 154:570 Nutescu E et al, Drug and dietary interactions of warfarin and novel oralanticoagulants: an update. J Thromb Thrombolysis 2011;31:326 Connolly SJ et al, Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361:1139. Active Investigators, Connolly SJ et al, Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 2009; 360:2066 Connolly SJ et al, Newly identified events in the RE-LY trail. N Engl J Med 2009;361:1139

Speaker(s):

You must be logged in and own this session in order to post comments.

Print Certificate
Review Answers
Print Transcript
Completed on: token-completed_on
Review Answers
Please select the appropriate credit type:
/
test_id: 
credits: 
completed on: 
rendered in: 
* - Indicates answer is required.
token-content

token-speaker-name
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
/
/
token-index
token-content
token-index
token-content