Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.

This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.

This podcast contains general information for educational purposes only. This is not

professional advice and should not be used in lieu of obtaining advice from a qualified health

care provider. And now on to the show. Welcome to Helix Talk episode 42. I'm your co-host

Dr. Cain. I'm Dr. Schumann. And I'm Dr. Patel. And today we're talking about

bridging, specifically the bridge trial, which came out in New England Journal of Medicine back

in August of 2015. But it's one of those landmark pivotal trials that is really going to impact

clinical practice. So we wanted to cover that today. Yeah, and let's just start out by a definition

of bridging. So basically, we call that bridging occurs when an anticoagulation coverage is provided by

either a low-molecular weight haparin, such as an oxoparin or dotaparin or haparin during

warfarin therapy interruption when the INAR is sub-therapeutic.

So there is that vulnerable window when we want to cover it with a shorter

acting anticoagulant. And these interruptions are usually for what we define as major procedures.

So we're not talking about things, you know, if you're minor dental procedures, minor skin surgeries,

or if they're doing, you know, I think even like a punch biopsy of the skin or cataract removal,

antacagulation is generally not interrupted with some exceptions,

but we're going to focus on more than generalities.

There's kind of two ways that you can do bridging.

One is more of a prophylactic regimen where you're kind of doing low doses or even intermediate

doses of, let's say, lovenox or any low molecular rate heparin.

But more commonly, you're actually therapeutically bridging

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