Monitoring of anticoagulants

Olson JD, Arkin CF, Brandt JT, et al. College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulation therapy Laboratory monitoring of unfractionated heparin therapy. Arch Pathol Lab Med 1998 122 782-788. 

A minor to modest pharmacokinetic interaction would be predicted, but as yet there appear to be no studies to confirm this. The case report and cohort study suggest that this interaction might be clinically important in some i n-dividuals. Therefore, it would be prudent to increase monitoring of anticoagulant control when any patient on a coumarin anticoagulant is given itraconazole. Further study is needed. 

The manufacturer of memantine notes that, although no causal relationship has been established, isolated cases of INR increases have been reported in patients treated with warfarin. They suggest close monitoring of anticoagulant effects. ... 

Harris, L.F., Rainey, R, Castro-Lopez, V., O Donnell, J.S., KiUard, A.J., 2013. A microfluidic anti-factor Xa assay device for point of care monitoring of anticoagulation therapy. Analyst 138 (17), 4769 776. 

Prothrombin time PT is performed by adding thromboplastin (tissue) factor and calcium to citrate-anticoagulated plasma, recalcifying the plasma, and measuring the clotting time. The major utility of PT is to measure the activity of the vitamin K-dependent factors II, VII, and X. The PT is used in evaluation of liver disease, to monitor warfarin anticoagulant effect, and to assess vitamin K deficiency. 

Antibodies Formation of antihirudin antibodies was observed in approximately 40% of HIT patients treated with lepirudin. This may increase the anticoagulant effect of lepirudin possibly because of delayed renal elimination of active lepirudin-antihirudin complexes. Therefore, strict monitoring of aPTT is necessary also during prolonged therapy. No evidence of neutralization of lepirudin or of allergic reactions associated with positive antibody test results was found. 

Ca-containing foods i effects OF anticoagulants EMS Monitor BP for HTN OD May cause NA symptomatic and supportive... 

PCN-sensitive staph) Action Bact icidal -1- cell wall synth Spectrum Most gram(+), including str Dose Adults. 250-500 mg PO q6h, q8h, q 12h Peds. 25-50 mg/kg/25h PO in 4 doses -1- in renal impair on empty stomach Caution [B, M] Contra Allergy Disp Tabs, susp SE GI upset, int stitial nephritis, anaphylaxis, convulsions Interactions -1- Effects W/ ASA, probenecid t effects OF MTX t risk of anaphylaxes W/BB -1- effects W/ chloramphenicol, macrolides, tetracyclines X effects OF OCPs EMS Monitor for sup Infxn T effects of anticoagulants monitor for signs of electrol5rte disturbances and h5 povolemia d/t D OD May cause N/D and Szs activated charcoal may be effective... 

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