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Anticoagulation Therapy: A Clinical Practice Guide

Anticoagulation Therapy: A Clinical Practice Guide

A Clinical Practice Guide

Dager, William E.

Editors: Nutescu, Edith A. | Gulseth, Michael P.

(2018)

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Book Details

Abstract

Anticoagulation therapy is an area of high impacts for pharmacists. Anticoagulants (blood thinners) require constant monitoring for renal function, pharmacokinetics, and interactions with other medicines. In some ways, these drugs can be considered a double-edged sword – while they save thousands of lives by preventing and treating strokes, pulmonary embolisms and DVTs, misuse can lead to complications ranging from worrisome to catastrophic. So it is essential that all pharmacists understand the benefits and risks associated with these high-risk medications.
 
Anticoagulation Therapy has become the go-to resource for pharmacists who treat and manage the millions of patients on anticoagulants in both inpatient and outpatient settings.  The second edition of this quick reference will continue with its heavy reliance on tables and bulleted lists. The second edition will feature new chapters on mechanical devices and considerations in special populations. The pioneering chapter on anticoagulation reversal will be divided into two chapters with one focusing on agents and one on patient considerations. Also new for this edition: 5 new chapters, 2 new appendixes, 3 updated appendixes.
 
William E. Dager, PharmD, BCPS, FCSHP, FCCP, FCCM, FASHP, MCCM is a Pharmacist Specialist, UC Davis Medical Center, Clinical Professor of Pharmacy, University of California, San Francisco; Clinical Professor of Medicine, School of University of California, Davis; and Clinical Professor of Pharmacy, Touro School of Pharmacy. He received his PharmD from the University of California, San Francisco in 1985 and completed a residency at the University of California Davis Medical Center (UCDMC). He also completed a nephrology pharmaceutical care preceptorship at the University of Pittsburgh, School of Pharmacy. He is a Board Certified Pharmacotherapy Specialist with added qualifications in cardiology. He is a Clinical Specialist at UCDMC where he manages difficult cases in anticoagulation, pharmacokinetics, and other critical care related situations. He is clinically active with the cardiology and cardiovascular surgery services and Director of the PGY2 residency in cardiology. He also is involved in teaching pharmacy students, residents, and other healthcare professionals, primarily as volunteer faculty.

Dager is a recipient of multiple teaching and mentoring awards including the American College of Clinical Pharmacy Best Practice Award. He is a reviewer and editorial board member for multiple medical journals including Chair of the Editorial Advisory Board panel on anticoagulation for the Annals of Pharmacotherapy. He is also a site coordinator for the ASHP Foundation anticoagulation preceptorship, has authored over 60 journal articles and over 10 book chapters, and is an active lecturer. His research has focused on ways to optimize the safe and effective use of medications in the midst of challenges that arise in patient care.
 
Michael P. Gulseth, PharmD, BCPS is Program Director for Anticoagulation Services, Department of Pharmaceutical Services, Sanford USD Medical Center, Sioux Falls, SD.  Dr. Gulseth received his Doctor of Pharmacy degree in 1999 from North Dakota State University in Fargo, ND. He completed residency training at United Hospital in St. Paul, MN. He is lead author and editor of Managing Anticoagulation Patients in the Hospital: the Inpatient Anticoagulation Service, published in 2007 by the American Society of Health-System Pharmacists.

Gulseth is a member of the Editorial Advisory Board of the American Journal of Health-System Pharmacy. Dr. Gulseth is an active member of several professional pharmacy organizations, including ASHP, the Minnesota Society of Health-System Pharmacists, the South Dakota Society of Health-System Pharmacists, and the American College of Clinical Pharmacy. His research interests include evaluation of antithrombotic therapies in the inpatient setting and evaluation of the benefits of pharmacist managed inpatient anticoagulation services.
 
Edith A. Nutescu, PharmD, MS CTS, FCCP is Professor and Head, Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy. She earned her PharmD degree with high honors at the University of Illinois at Chicago College of Pharmacy. After graduation, she went on to complete an ASHP-accredited pharmacy practice residency at Lutheran General Hospital–Advocate Health Care and a primary care specialty residency at the University of Illinois at Chicago Medical Center. As a clinician and educator, she has contributed extensively to the care of patients and the education of students and healthcare providers on topics related to vascular diseases and antithrombotic medication safety.

Nutescu was honored with the 2010 Distinguished Service Award from the American Society of Health-System Pharmacists, where she has been an active member. She has served on the Home, Ambulatory, and Chronic Care Practitioners Programming Committee and on the Section of Clinical Specialists and Scientists Committee on Nominations. She has been a presenter and meeting programming associate for several scientific and clinical programs at ASHP Midyear Meetings. She has also been active on the Illinois Council of Health-System Pharmacy. Dr. Nutescu was the only pharmacist member nominated to serve on the Steering Committee for the National Quality Forum and the Joint Commission on the Accreditation of Healthcare Organizations–National Consensus Standards for the Prevention and Care of Venous Thrombosis. She has been recognized as a Fellow of the American College of Clinical Pharmacy and is the 2009 recipient of the American College of Clinical Pharmacy’s Clinical Practice Award, one of the highest distinctions awarded in clinical pharmacy.
 

Table of Contents

Section Title Page Action Price
Dedication 3
Contents 5
Contributing Editors 7
Contributors 7
Preface 11
Acknowledgments 13
Abbreviations 15
Part I. Anticoagulation Medication Management 21
Ch 1. Introduction to Anticoagulation Management 23
Ch 2. Warfarin 33
Ch 3. Unfractionated Heparin 55
Ch 4. Low Molecular Weight Heparin and Fondaparinux 85
Ch 5. Parenteral Direct Thrombin Inhibitors 105
Ch 6. Thrombolytic Considerations When Used with Anticoagulants 127
Ch 7. Direct Oral Anticoagulants 151
Ch 8. Anticoagulation Reversal: Part I—Pharmacology of Agents Used for Reversal 183
Ch 9. Anticoagulation Reversal: Part II—Clinical Application 203
Ch 10. Transitions in Care—Periprocedural Bridging and Transitions Between Agents 243
Ch 11. Considerations in Special Populations 271
Part II. Conditions Requiring Anticoagulation Therapy 301
Ch 12. Venous Thromboembolism Prevention 303
Ch 13. Venous Thromboembolism Treatment 333
Ch 14. Atrial Fibrillation 367
Ch 15. Acute Coronary Syndromes 383
Ch 16. Prosthetic Heart Valves 413
Ch 17. Mechanical Circulatory Support Devices 425
Ch 18. Heparin-Induced Thrombocytopenia 443
Ch 19. Pregnancy 469
Ch 20. Pediatrics 501
Part III. Practical Measuring, Monitoring, and Coagulation Laboratory\r\nInsights 525
Ch 21. Coagulation Laboratory Considerations 527
Ch 22. Thrombophilias 569
Part IV. Essentials for Practice Success 595
Ch 23. Models and Standards of Anticoagulation Care Delivery 597
Ch 24. Regulatory and Practice Resources 625
Appendixes 635
Appendix A. Coagulation Cascade 637
Appendix B. Agents Implicated in Drug-Induced Thromboembolic Diseases 638
Appendix C. Nutrition Influence on Anticoagulation 643
Appendix D. Anticoagulants in Management of Ischemic Stroke or Transient Ischemic Attacks 645
Appendix E. Citrate Anticoagulation 647
Appendix F. Examples of Available Bleeding Definitions 649
Appendix G. Types of CNS Hemorrhage 651
Appendix H. Disseminated Intravascular Coagulation 652
Appendix I. Nondrug Causes of Thrombocytopenia 653
Appendix J. Drug-Related Causes of Thrombocytopenia 654
Appendix K. Examples of Transfusion-Related Reactions 657
Appendix L. Considerations for Transitioning from aPTT to Anti-Xa to Manage Heparin Therapy 658
Appendix M. PIONEER AF-PCI 661
Appendix N. Betrixaban APEX Trial 662
Index 663