Daily Bolus of LR: Pradaxa

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November 27, 2012 by dailybolusoflr

·         Pradaxa (Dabigatran Etexilate Mesylate) is a direct thrombin inhibitor that leads to inhibition or clot formation or stabilization of clot
·         Is FDA approved for use in patients with atrial fibrillation
·         Is non-FDA approved but used in patients with thromboembolic disease both for prophylaxis and treatment
·         Unlike warfarin, there is no need for monitoring, which is an appealing part of the drug
·         Dose adjustments should be made in patients with renal insufficiency (80% clearance from the kidney; half life around 12 hours)
·         There have been recent lawsuits related to mortality from bleeding (usually in trauma patients) as, unlike warfarin, there is no reversal agent.  This is the reason many doctors are opposed to its use
o   Treatment for patients who are bleeding involve use of FFP and in severe instances cryoprecipitate, as the risk for thromboembolic phenomenon is higher with its use
Ref:  Micromedex and  Circulation.2012; 126: 133-137

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