074 - Taking a break: perioperative management of anticoagulants and antiplatelets, Part I

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 20 February 2018

⏱️ 31 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we will discuss some important factors to consider in management of various anticoagulants. We will also provide agent specific pharmacodynamic and pharmacokinetic based recommendations.

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.5	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show. Welcome to Helix Talk episode 74. I'm your co-host Dr. Kane.
0:35.5	I'm Dr. Schumann. And I'm Dr. Patel.
0:43.4	And the title of our episode today is Taking a Break, Parioperative Management of Anticoagulants.
0:52.5	In this episode, we hope to accomplish discussing some of the factors that we consider in the management of various anticoagulants, especially around the procedures.
0:56.3	And we hope to provide you a synopsis of what are some of these agent-specific pharmacokinetic and pharmacodynamic factors that would go into making
1:02.7	recommendations for peri-procedural monitoring. So Dr. Patel, A, this is a super relevant area for
1:09.5	pharmacy to play a role. I get a ton of questions
1:12.8	about anticoagulance, when to start, stop, how to bridge, things like that. So this is for sure
1:17.7	a relevant topic. And for me, I learned best with a case. So would it be possible for you to kick
1:22.8	us off with a great clinical case example? Absolutely. This case actually is a real patient case that just happened to me last week in the clinic.
1:30.7	So it's kind of like clinic.
1:32.2	You have to play around with some of your hospital physicians and surgeon's counterports as well.
1:38.0	The patient was a 55-year-old African-American female who was on Warfriend for Recurrent VT.
1:42.9	Her last DVT was seven years ago.
1:45.8	So we had her on warfarin for that recurrent VT prevention with the goal I and R of 2 to 3.
1:51.2	Her dose was pretty stable at 7.5 milligrams daily. However, what threw wrench in the process
1:58.6	was that she was debilitated by bilateral OA-related knee pain. And she was
2:04.3	consulting with this rheumatologist who kept on giving her steroverses and in particular steroid injections
	...

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