Noval anticoagulants - dabigatran Flashcards
1
Q
What is the brand name for dabigatran?
A
• Dabigatran – Pradaxa
2
Q
What is the method of action of dabigatran?
A
- Competitive direct free and fibrin bound thrombin inhibitor
- Thrombin allows the conversion of fibrinogen → fibrin therefore a thrombus cannot be formed
3
Q
What are the indications for dabigatran?
A
- Prevention of VTE in those who have undergone elective hip/knee surgery or total knee replacement surgery
- Prophylaxis of systemic emboli in non valvular AF and one other risk factor (TIA, previous stroke, symptomatic heart failure, diabetes, hypertension, age >75)
- Treatment of DVT
- Treatment of PE
- Prevention of recurrent DVT
- Prevention of recurrent PE
4
Q
What are the contraindication for dabigatran?
A
- Severely reduced renal function
- Current bleeding
- Condition that increases risk of serious bleed
- Severely reduced liver function/liver disease
- Artificial valve replacement
- Surgery – should be stopped 24 hours before
5
Q
What are the side effects of dabigatran?
A
- Bleeding – nose, stomach, urine etc.
- Anaemia
- Abnormal liver enzyme results
- Haematoma/bruising
- GI upset
- Wound secretion
6
Q
What are the interactions with dabigatran?
A
- Oral ketoconazole/itraconazole - ↑ plasma concertation of dabigatran
- Cyclosporine (organ transplant)
- Dronedarone/Amiodarone/verapamil - ↑ plasma concertation of dabigatran
- Anticoagulants/anti-platelets - ↑ risk of bleeding
- NSAIDs - ↑ risk of bleeding
- St John’s Wort - ↓ plasma concertation of dabigatran
- SSRI - ↑ risk of bleeding
- Rifampicin - ↓ plasma concertation of dabigatran
- Clarithromycin - ↑ plasma concertation of dabigatran
7
Q
What organ eliminates dabigatran?
A
Kidney
