Beginning an anticoagulant therapy can be a scary and daunting task for any patient. Even more so, for the patient who is naive to the medications and ramifications if not taken properly. Having a complete understanding of both the new and old therapies is imperative. There are numerous circumstances that warrant anticoagulation therapy. This study focuses on the use of anticoagulants for preventing strokes in patients with atrial fibrillation, more specifically, the use of Warfarin versus Pradaxa. According to Coppens, Hart, and Eikelboom (2013), stroke related incidences in patients with atrial fibrillation rise drastically with age. Furthermore, the morbidity and mortality rates, post stroke, are significantly greater in patients with atrial fibrillation as opposed to those without (Coppens et al., 2013). This confirms an ever growing need for reliable blood thinners. Both medications discussed are used to treat and/or prevent blood clots from forming; however there are vast differences between them. The most notable differences are the requirements for routine laboratory work, the availability of reversal agents or antidotes, and factors that contribute to patient compliance such as medication cost. Although anticoagulants play a crucial therapeutic role, the convenience of incorporating a regimen into one’s life style is equally important.
For many years warfarin has been the anticoagulant of choice. Its reliability supersedes the newer alternatives. A major inconvenience, from the patient’s perspective, of taking warfarin is the need for routine laboratory work. Determining the patient’s appropriate dosage is directly influenced by their international normalized ratio (INR). Although inconvenient, the frequent visits to th...
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... (Grave, 2012. p32). Whether it's the cost of the medication or the cost of physically getting to routine appointments there are obstacles for all involved. Until the gap in health care disparities is closed, this will continue to be a hindrance for many.
In conclusion, there are clearly pro's and con's for both medications. Each patient is unique and requires a personalized plan of care. One medication could surely prove to be the better option in the appropriate situation. Careful consideration of the patient’s health, support system, and goals should be thoroughly assessed before choosing either therapy. Following physicians orders, being educated on anticoagulants, contraindications, and adverse effects is key to greater success. Overall, there are serious risks involved with taking pradaxa and warfarin, but they save lives and that is what is most important.
Ischemic Stroke is caused due to a blood clot in an area of the brain, leading to loss of neural function if last for more than 24 hours. In the United States, ischemic stroke affects 2.7% of men and 2.5% of women of age range 18 years and older. In addition, it has reported that annually about 610,000 and 185,000 of new strokes and recurrent strokes cases occur in US1. Moreover, it has reported that patients who have suffered from a stroke have more chances of recurrent stroke, Myocardial infarction, and death from vascular causes2. One of the risk factor of ischemic stroke is formation of plaque in the blood vessels causing blood clot3. Several randomized trials have also reported that antiplatelet medications are efficient in preventing recurrences of stroke in patients who had an incident of ischemic stroke. Antiplatelet medications for preventing recurrences of stroke are aspirin, combination of aspirin and extended-release dipyridamole, and clopidogrel alone4. It ha...
27-Ussia GP, Scarabelli M, Mulè M, et al. Dual antiplatelet therapy versus aspirin alone in patients undergoing transcatheter aortic valve implantation.Am J Cardiol 2011;108:1772–6.
(15)Patel M, Mahaffey K, Garg J, Pan G, Singer D, Hacke W, Breithardt G, Halperin J, Hankey G, Piccini J, Becker R, Nessel C, Paolini J, Berkowitz S, Fox K.. (2011). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.. New England Journal Of Medicine. 365 (10), 883-91.
“Chronic diseases and illnesses are the leading causes of death and disability in the United States” (CDC.gov, 2014). These types of illnesses are the most common health problems that people in this country face today and they are also the most preventable (CDC.gov, 2014). Every year the cost to help care for and manage people with these types of illnesses increases and there is less being done about educating people about prevention. Venous Thromboembolism is one such chronic disease that is very deadly but also very preventable if the right precautions are taken. This paper will aim to educate about the disease, courses and costs of treatment, clinical microsystems that are involved and what barriers if any exist to achieving generative relationships among the various clinical microsystems involved.
...e of warfarin over dabigatran as the preferred anticoagulant for the prevention of thromboembolic and bleeding complications in patients with mechanical heart valves.
Overall adverse effects (AE) and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin100 mg (5.2%). Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin vs sitagliptin and sitagliptin/placebo. Hypoglycemia incidence was higher with canagliflozin over the 52 weeks (6.8%) clinical study. Urinary tract infections (UTIs) were similar across groups over 52 weeks. One death was reported in all treatment arms except for canagliflozin 100mg.5
The human body is dependent on interconnectedness of its systems to maintain homeostasis. Internal and external factors can potentially contribute to a disruption of homeostasis. If the body is not returned to homeostasis by negative feedback mechanisms then complications arise which can be detected by a battery of tests (Museum of Science & Industry, 2013). For example, a 40-year-old man enters the clinic with complaining of chest pains, the negative feedback systems have not returned the body to homeostasis. A variety of tests are performed to determine what is occurring. The objective data states that the patient has elevated troponin levels, which confirm a mild heart attack. Hematocrit levels are normal; however, platelet counts are recorded at >600x 103 /µl, and there is also no direct evidence for iron deficiency. Subjective data reveals that the patient complains of a throbbing and burning sensation in the hands and feet, and his family has a history of heart problems. To determine the patient’s condition the attending physician must understand the anatomy of the body.
Up to our knowledge, there are no randomized clinical trials that compared Pitavastatin with Atorvastatin with the same endpoints that we set for this trial. We believe that establishing a clinical evidence to support the use of Pitavastatin as an alternative to the most commonly used statin in a clinical setting is of great importance. Moreover, there is no evidence that Pitavastatin can reduce both cardiovascular and cerebrovascular events and related deaths, which this study is going to test.
Despite the established health care facilities in the United States, most citizens do not have access to proper medical care. We must appreciate from the very onset that a healthy and strong nation must have a proper health care system. Such a health system should be available and affordable to all. The cost of health services is high. In fact, the ...
No citizen shale ever be ignored no matter their race, state of health, or class. In the US “barriers generally stem from forces within the organizational environment of the health care delivery system or within the broader social system itself” (Barr, 2011, p. 273). This is why health policy scholars need to study health disparities so that equal care can ultimately be reached. Currently some disparities that are obvious in society are unequal dispersion and quality of care between racial groups, genders, and those with low middle class income. The health care system needs to be fixed and in order for that to happen health scholars must study better procedures so that the best possible outcome can be reached for the American
Healthcare disparities are when there are inequalities or differences of the conditions of health and the quality of care that is received among specific groups of people such as African Americans, Caucasians, Asians, or Hispanics. Not only does it occur between racial and ethnic groups, health disparities can happen between males and females as well. Minorities have the worst healthcare outcomes, higher death rates, and are more prone to terminal diseases. For African American men and women, some of the most common health disparities are diabetes, cancer, hypertension, cardiovascular disease, and HIV infections. Some factors that can contribute to disparities are healthcare access, transportation, specialist referrals, and non-effective communication with patients. There is also much racism that still occurs today, which can be another reason African Americans may be mistreated with their healthcare. “Although both black and white patients tended not to endorse the existence of racism in the medical system, African Americans patients were more likely to perceive racism” (Laveist, Nickerson, Bowie, 2000). Over the years, the health care system has made improvements but some Americans, such as African Americans, are still being treating unequally when wanting the same care they desire as everyone else.
Nearly every American can agree that our current health care system needs reforms. Primarily do to the fact that 45.7 million Americans are without health insurance. That's approximately 16 percent of Americans who sometimes have to do without healthcare, or face crucial financial responsibility. The main issues are admission to healthcare, and the affordability of health care. Before 1920, doctors didn't know enough about diseases to really provide useful care to sick people. Therefore the...
A recent study in the Journal of the American Medical Association stressed the importance of onset to treatment time as a factor in patient clinical outcomes. The study also indicated that early treatment of ischemic stroke with intravenous recombinant tissue plasminogen activator (rtPA) resulted in fewer deaths, intracranial hemorrhage, and an overall better prognosis for patients post-stroke (Saver et al., 2012).
Precision of a patient’s intravenous medication is essential; it must be safe from. contamination, toxicity, and side effects. Most people believe these medications are compounded or mixed by a trained and licensed individual. However, this is inaccurate because the pharmacy technician actually compounds a large percentage of a patient’s medications. Compounding involves a technician’s math skills, aseptic technique, and professional ethics.... ...
... you should take baby aspirin (81 mg). The earlier a patient takes preventative measures the less a patient has to worry about taking other medication such Warfarin which have many adverse side effects such as excessive bleeding. Patients need to continuously check legs for any signs and symptoms of DVT.