Warfarin

After electrical cardioversion, the doctor may prescribe anti-arrhythmic medications to help prevent future episodes of atrial fibrillation. Medications may include: dofetilde (Tikosyn), flecainide, propafenone (Rythmol), amiodarone (Cordarone, Pacerone), and sotalol (Betapace, Sorine). Although these drugs may help maintain a normal heart rhythm, they can cause side effects, including: nausea, dizziness, and fatigue. Rarely, they may cause ventricular arrhythmias – life-threatening rhythm…

1. In a re-sequencing study to detect genetic variation that influences expression and inducibility of cytochrome P450 (CYP) enzymes, novel mutations are detected in the constitutive androstane receptor (CAR; NR1I3), a nuclear hormone receptor that acts as a transcription factor and controls the expression of CYPs including CYP34. Activation of CAR induces (increases) the expression of CYP enzymes. An alignment of the amino acid sequence of human, monkey, rat, and mouse CARs is indicated below.…

mL/min to use the 110 mg BID dose. A subgroup analysis of the RE-LY trial (7) which included patients with CrCl 30-49 mL/min demonstrated a lower risk of stroke/systemic embolism and a similar risk of major bleeding with dabigatran in comparison to warfarin (8). Based on a pharmacokinetic modeling, FDA but not EMA approved a lower dose of dabigatran 75 mg BID in patients with CrCl 15-30 ml/mL (9, 10).…

Pharmacogenomics is the study of how genes affect a person’s response to drug. A new emerging field which hold the combinational knowledge of pharmacology and genomics in order to provide not only safe and effective medication but also have the high degree of acceptance with the genetic make up of the patients. Current status of dose regimen followed ”one size fits all”. But is very tiresome job to predict these therapeutic responses in all the patient. Some times dominating negative side…

Code Stroke in Action Kathryn Sheehy University of San Diego MEPN 560 April 6,2015 Code Stroke in Action The clock just struck 0752 in room five of the Emergency Department when the medics called in. They reported that they had an eighty-two year-old female, who had initials K.R., demonstrating left sided facial droop and aphasia. According to the ACLS stroke scale, if one has facial droop, difficulty speaking or arm drift they are 72% likely to have a stroke (Carl). Her last…

From the patient’s medication list HCTZ, Warfarin and Calcium Acetate are only drugs that causes interaction with other drugs on the list. HCTZ can interact with MiraLax or Vitamin D causing electrolyte imbalance. Warfarin use with omega 3, melatonin or Gingko Biolba can pose risk for bleeding. Finally, Calcium Acetate use with Fosamax can reduce the effect of Fosamax, while use with Vitamin D can cause hypercalcemia. According to medication interaction checker by Medscape, the chance for these…

Restrictive cardiomyopathy (RCM) is also known as Diastolic Heart Failure, this “is characterized by restrictive filling and reduced diastolic volume of either [one] or both ventricles with normal or near normal systolic function and wall thickness.” There are many types of Cardiomyopathy, Restrictive cardiomyopathy is the least common type. The tell-tale sign of RCM is diastolic dysfunction. Diastolic dysfunction is when the heart does not fill up correctly, either too slowly or too quickly.…

(Urinary Tract Infection)? Drink plenty of water to flush out the bacteria. Berry or cranberry juice may also help prevent urinary tract infections. However, if you are taking warfarin, check with your doctor before drinking cranberry juice to prevent urinary tract infections. Your doctor may adjust the dose of your warfarin or required blood tests to adjust the dose may consume.…

According to the AHRQ guidelines management of atrial fibrillation (Afib) or atrial flutter (AFL) is to provide a reliable approach of care across. Guidelines are as follow: Diagnosis/Evaluation • Assessment of signs and symptoms • Electrocardiogram (ECG) • Physical exam • Laboratory test • Imaging (chest x-ray, echocardiogram) • Continuous telemetry monitoring Treatment/Management • Resuscitation and consideration of other conditions contributing to instability • Direct current…

Catheterization Appropriate nursing skill and great technology are required to provide a safe and comfortable environment for the patient in the catheterization laboratory. Having a critical care experience, basic life support (BLS) and advanced cardiac life support (ACLS) certification, and knowledge of sophisticated equipment such as (IABP) are required for competent care of the patients undergoing invasive cardiac procedures. Although it may seem repetitive,…