Anticoagulant Options for the Patient: New versus Old

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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.
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