atrial fibrilation

Question 1

Why do patients who are diagnosed with atrial fibrillation need to be anticoagulated?

Answer 1

• due to increased risk of blood clot formation
• AFib can cause blood to pool in the atria - leading to clots

Question 2

warfarin

Answer 2

• vitamin K antagonist
• inhibit the production of vitamin K by vitamin K epoxide reductase
• enables Vitamin K for the synthesis of clotting factors II, VII, IX, and X

Question 3

how can warfarin therapy be reversed?

Answer 3

• the omission of a dose of warfarin
• administration of an oral or intravenous dose of vitamin K
• use of fresh frozen plasma

Question 4

junior doctor mistakenly decides to stop dalteparin after the patient has his first dose of warfarin. Why should the doctor not have stopped the dalteparin therapy initially?

Answer 4

• Dalteparin acts more rapidly than warfarin
• if used at the same time ensure continuous anticoagulation and prevent an increased risk of clotting during the transition phase.
• stopping dalteparin abruptly could potentially leave the patient temporarily unprotected against clot formation until the warfarin reaches its full anticoagulant effect