Vitamin K Epoxide Reductases: OXIDOREDUCTASES which mediate vitamin K metabolism by converting inactive vitamin K 2,3-epoxide to active vitamin K.Acenocoumarol: A coumarin that is used as an anticoagulant. Its actions and uses are similar to those of WARFARIN. (From Martindale, The Extra Pharmacopoeia, 30th ed, p233)Phenprocoumon: Coumarin derivative that acts as a long acting oral anticoagulant.Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.International Normalized Ratio: System established by the World Health Organization and the International Committee on Thrombosis and Hemostasis for monitoring and reporting blood coagulation tests. Under this system, results are standardized using the International Sensitivity Index for the particular test reagent/instrument combination used.Anticoagulants: Agents that prevent clotting.Coumarins: Synthetic or naturally occurring substances related to coumarin, the delta-lactone of coumarinic acid.Mixed Function Oxygenases: Widely distributed enzymes that carry out oxidation-reduction reactions in which one atom of the oxygen molecule is incorporated into the organic substrate; the other oxygen atom is reduced and combined with hydrogen ions to form water. They are also known as monooxygenases or hydroxylases. These reactions require two substrates as reductants for each of the two oxygen atoms. There are different classes of monooxygenases depending on the type of hydrogen-providing cosubstrate (COENZYMES) required in the mixed-function oxidation.Pharmacogenetics: A branch of genetics which deals with the genetic variability in individual responses to drugs and drug metabolism (BIOTRANSFORMATION).Vitamin K: A lipid cofactor that is required for normal blood clotting. Several forms of vitamin K have been identified: VITAMIN K 1 (phytomenadione) derived from plants, VITAMIN K 2 (menaquinone) from bacteria, and synthetic naphthoquinone provitamins, VITAMIN K 3 (menadione). Vitamin K 3 provitamins, after being alkylated in vivo, exhibit the antifibrinolytic activity of vitamin K. Green leafy vegetables, liver, cheese, butter, and egg yolk are good sources of vitamin K.Dictionaries, MedicalDictionaries as Topic: Lists of words, usually in alphabetical order, giving information about form, pronunciation, etymology, grammar, and meaning.Drug Dosage Calculations: Math calculations done for preparing appropriate doses of medicines, taking into account conversions of WEIGHTS AND MEASURES. Mistakes are one of the sources of MEDICATION ERRORS.Dictionaries, ChemicalSteroid 16-alpha-Hydroxylase: A liver microsomal cytochrome P450 enzyme that catalyzes the 16-alpha-hydroxylation of a broad spectrum of steroids, fatty acids, and xenobiotics in the presence of molecular oxygen and NADPH-FERRIHEMOPROTEIN REDUCTASE. This enzyme is encoded by a number of genes from several CYP2 subfamilies.Chronic Pain: Aching sensation that persists for more than a few months. It may or may not be associated with trauma or disease, and may persist after the initial injury has healed. Its localization, character, and timing are more vague than with acute pain.Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Pain Management: A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Pain Threshold: Amount of stimulation required before the sensation of pain is experienced.Pain, Postoperative: Pain during the period after surgery.Tandem Mass Spectrometry: A mass spectrometry technique using two (MS/MS) or more mass analyzers. With two in tandem, the precursor ions are mass-selected by a first mass analyzer, and focused into a collision region where they are then fragmented into product ions which are then characterized by a second mass analyzer. A variety of techniques are used to separate the compounds, ionize them, and introduce them to the first mass analyzer. For example, for in GC-MS/MS, GAS CHROMATOGRAPHY-MASS SPECTROMETRY is involved in separating relatively small compounds by GAS CHROMATOGRAPHY prior to injecting them into an ionization chamber for the mass selection.Chromatography, Liquid: Chromatographic techniques in which the mobile phase is a liquid.Chromatography, High Pressure Liquid: Liquid chromatographic techniques which feature high inlet pressures, high sensitivity, and high speed.Solid Phase Extraction: An extraction method that separates analytes using a solid phase and a liquid phase. It is used for preparative sample cleanup before analysis by CHROMATOGRAPHY and other analytical methods.Mass Spectrometry: An analytical method used in determining the identity of a chemical based on its mass using mass analyzers/mass spectrometers.Spectrometry, Mass, Electrospray Ionization: A mass spectrometry technique used for analysis of nonvolatile compounds such as proteins and macromolecules. The technique involves preparing electrically charged droplets from analyte molecules dissolved in solvent. The electrically charged droplets enter a vacuum chamber where the solvent is evaporated. Evaporation of solvent reduces the droplet size, thereby increasing the coulombic repulsion within the droplet. As the charged droplets get smaller, the excess charge within them causes them to disintegrate and release analyte molecules. The volatilized analyte molecules are then analyzed by mass spectrometry.Calibration: Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency or other output.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Limit of Detection: Concentration or quantity that is derived from the smallest measure that can be detected with reasonable certainty for a given analytical procedure.Reference Standards: A basis of value established for the measure of quantity, weight, extent or quality, e.g. weight standards, standard solutions, methods, techniques, and procedures used in diagnosis and therapy.Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia.Umbelliferones: 7-Hydroxycoumarins. Substances present in many plants, especially umbelliferae. Umbelliferones are used in sunscreen preparations and may be mutagenic. Their derivatives are used in liver therapy, as reagents, plant growth factors, sunscreens, insecticides, parasiticides, choleretics, spasmolytics, etc.4-Hydroxycoumarins: Substances found in many plants, containing the 4-hydroxycoumarin radical. They interfere with vitamin K and the blood clotting mechanism, are tightly protein-bound, inhibit mitochondrial and microsomal enzymes, and are used as oral anticoagulants.2-Hydroxy-5-nitrobenzyl Bromide: A chemical reagent that reacts with and modifies chemically the tryptophan portion of protein molecules. Used for 'active site' enzyme studies and other protein studies. Sometimes referred to as Koshland's reagent.Thrombelastography: Use of a thrombelastograph, which provides a continuous graphic record of the physical shape of a clot during fibrin formation and subsequent lysis.Heart Valves: Flaps of tissue that prevent regurgitation of BLOOD from the HEART VENTRICLES to the HEART ATRIA or from the PULMONARY ARTERIES or AORTA to the ventricles.Blood Coagulation: The process of the interaction of BLOOD COAGULATION FACTORS that results in an insoluble FIBRIN clot.Blood Coagulation Tests: Laboratory tests for evaluating the individual's clotting mechanism.Whole Blood Coagulation Time: The time required by whole blood to produce a visible clot.Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation.Factor VII: Heat- and storage-stable plasma protein that is activated by tissue thromboplastin to form factor VIIa in the extrinsic pathway of blood coagulation. The activated form then catalyzes the activation of factor X to factor Xa.Polymorphism, Single Nucleotide: A single nucleotide variation in a genetic sequence that occurs at appreciable frequency in the population.Cytochrome P-450 Enzyme System: A superfamily of hundreds of closely related HEMEPROTEINS found throughout the phylogenetic spectrum, from animals, plants, fungi, to bacteria. They include numerous complex monooxygenases (MIXED FUNCTION OXYGENASES). In animals, these P-450 enzymes serve two major functions: (1) biosynthesis of steroids, fatty acids, and bile acids; (2) metabolism of endogenous and a wide variety of exogenous substrates, such as toxins and drugs (BIOTRANSFORMATION). They are classified, according to their sequence similarities rather than functions, into CYP gene families (>40% homology) and subfamilies (>59% homology). For example, enzymes from the CYP1, CYP2, and CYP3 gene families are responsible for most drug metabolism.Polymorphism, Genetic: The regular and simultaneous occurrence in a single interbreeding population of two or more discontinuous genotypes. The concept includes differences in genotypes ranging in size from a single nucleotide site (POLYMORPHISM, SINGLE NUCLEOTIDE) to large nucleotide sequences visible at a chromosomal level.Genotype: The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS.Commerce: The interchange of goods or commodities, especially on a large scale, between different countries or between populations within the same country. It includes trade (the buying, selling, or exchanging of commodities, whether wholesale or retail) and business (the purchase and sale of goods to make a profit). (From Random House Unabridged Dictionary, 2d ed, p411, p2005 & p283)Therapeutic Equivalency: The relative equivalency in the efficacy of different modes of treatment of a disease, most often used to compare the efficacy of different pharmaceuticals to treat a given disease.Femininity: Female-associated sex-specific social roles and behaviors unrelated to biologic function.Pasteurellosis, Pneumonic: Bovine respiratory disease found in animals that have been shipped or exposed to CATTLE recently transported. The major agent responsible for the disease is MANNHEIMIA HAEMOLYTICA and less commonly, PASTEURELLA MULTOCIDA or HAEMOPHILUS SOMNUS. All three agents are normal inhabitants of the bovine nasal pharyngeal mucosa but not the LUNG. They are considered opportunistic pathogens following STRESS, PHYSIOLOGICAL and/or a viral infection. The resulting bacterial fibrinous BRONCHOPNEUMONIA is often fatal.Ships: Large vessels propelled by power or sail used for transportation on rivers, seas, oceans, or other navigable waters. Boats are smaller vessels propelled by oars, paddles, sail, or power; they may or may not have a deck.ThiazinesSweetening Agents: Substances that sweeten food, beverages, medications, etc., such as sugar, saccharine or other low-calorie synthetic products. (From Random House Unabridged Dictionary, 2d ed)TriazolesAlloxanCarcinogenicity Tests: Tests to experimentally measure the tumor-producing/cancer cell-producing potency of an agent by administering the agent (e.g., benzanthracenes) and observing the quantity of tumors or the cell transformation developed over a given period of time. The carcinogenicity value is usually measured as milligrams of agent administered per tumor developed. Though this test differs from the DNA-repair and bacterial microsome MUTAGENICITY TESTS, researchers often attempt to correlate the finding of carcinogenicity values and mutagenicity values.Albendazole: A benzimidazole broad-spectrum anthelmintic structurally related to MEBENDAZOLE that is effective against many diseases. (From Martindale, The Extra Pharmacopoeia, 30th ed, p38)Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form. These include binders, matrix, base or diluent in pills, tablets, creams, salves, etc.Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.Drug Contamination: The presence of organisms, or any foreign material that makes a drug preparation impure.
(1/76) A placebo-controlled study of interaction between nabumetone and acenocoumarol.

AIMS: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients treated with oral anticoagulants is generally discouraged due to the risk of interactions that could increase the risk of bleeding complications. Available data suggest the NSAID, nabumetone, does not produce such an interaction. We investigated whether nabumetone would interact with acenocoumarol, an oral anticoagulant widely used in some European countries. METHODS: A double-blind, randomized, placebo-controlled study was conducted evaluating nabumetone (1-2 g daily for up to 4 weeks) in osteoarthritis patients with thromboembolic risk previously stabilized on acenocoumarol. The primary efficacy end point was the proportion of patients whose International Normalized Ratio (INR) remained within established margins and whose acenocoumarol dose was not changed. Fifty-six patients were randomized to receive nabumetone (n=27) or placebo (n=29). RESULTS: Eighteen patients in each group (67% for nabumetone and 62% for placebo) completed the study without showing INR or acenocoumarol dose changes, and were considered as study successes. Nine patients (33%) with nabumetone and 11 (38%) with placebo were considered study failures in the intention-to-treat analysis (one patient on nabumetone and four on placebo did not complete the study due to reasons not related to INR and acenocoumarol dose changes). No significant differences were found between groups with regard to study successes. There were two minor bleeding complications, one in each group. Six patients per group presented with eight adverse experiences in each group. CONCLUSIONS: Treatment with nabumetone did not alter INR levels compared with placebo in patients stabilized on oral acenocoumarol who require NSAID therapy. These results suggest that nabumetone does not produce a clinically relevant interaction with acenocoumarol. In orally anticoagulated patients without other associated risk factors, treatment with nabumetone for up to 4 weeks does not require increased monitoring of INR levels.  (+info)

(2/76) Prediction of pharmacokinetic drug/drug interactions from In vitro data: interactions of the nonsteroidal anti-inflammatory drug lornoxicam with oral anticoagulants.

CYP2C9 is involved in the metabolism of the oral anticoagulants warfarin, phenprocoumon, and acenocoumarol. It is also responsible for the 5'-hydroxylation of the nonsteroidal anti-inflammatory drug lornoxicam. Therefore, lornoxicam and the oral anticoagulants are potential inhibitors of their metabolism. Their inhibitory potency was investigated in microsomes from six human livers. An approach to predict pharmacokinetic interactions of lornoxicam from in vitro inhibition data was developed. Where possible, the forecasts were verified by comparison with data from clinical interaction studies. The following increases in steady-state plasma concentrations or areas under the plasma concentration-time curve of the oral anticoagulants by concomitant lornoxicam medication were predicted (values in parentheses are for healthy volunteers): (S)-warfarin, 1. 58-fold (1.32-fold for racemate); racemic-acenocoumarol, 1.28-fold (1.09-fold); (R)-acenocoumarol, 1.10-fold (1.0-fold); racemic-phenprocoumon, 1.11-fold (1.18-fold); and (S)-phenprocoumon, 1.13-fold (1.24-fold). Lornoxicam 5'-hydroxylation was competitively inhibited in vitro by both phenprocoumon (K(i) = 1.2 +/- 0.4 microM) and acenocoumarol (K(i) = 5.5 +/- 3.5 microM). The present results indicate that relatively close predictions of the interactions of lornoxicam with oral anticoagulants from in vitro data are possible under the assumption that hepatic lornoxicam concentrations are similar to its total plasma concentrations. The degree of pharmacokinetic interactions exhibited by oral anticoagulants and lornoxicam is dependent on the respective contribution of CYP2C9 to their total clearance.  (+info)

(3/76) Assessment of patient capability to self-adjust oral anticoagulant dose: a multicenter study on home use of portable prothrombin time monitor (COAGUCHECK).

BACKGROUND AND OBJECTIVES: Self-testing and self-monitoring with portable prothrombin time (PT) monitors has been shown to be feasible and safe. However the ability of patients on chronic oral anticoagulant therapy (OAT) to self-adjust their dose without specific training has never been properly evaluated. The aims of this study were to evaluate: 1) the ability of patients on chronic OAT to self-adjust their dose without specific training; 2) the integration of a portable PT monitor (Coagucheck, Roche Diagnostics, Germany) for home use into routine patient care in anticoagulation clinics. DESIGN AND METHODS: A nested case-control study was conducted in four centers of the Italian Federation of Anticoagulation Clinics (FCSA). Patients (n=78) on stable OAT for at least 6 months (cases: 47 men, 31 women, age range: 18-75 years) were enrolled on a volunteer basis after passing an Abbreviated Mental Test and providing informed consent. After three instruction sessions on the use of Coaguchek, subjects performed the PT test at home, communicated the INR results to the Center and suggested the dose adjustment and date for next control as they thought appropriate. However, they were requested to follow the prescription made by the Center. Controls (78 subjects) matched by age (+/- 5 years), sex and therapeutic range with the cases, were selected from among those who attended the anticoagulation clinics and managed by usual care. RESULTS: When compared with the dose prescribed by the Clinic, the dose suggested by warfarin and acenocoumarol users was equal to or within +/- 6% of the mean weekly dose in 80% and 82% of suggestions, respectively. Time spent in the therapeutic range during the study was the same (80%) for cases and controls. INTERPRETATION AND CONCLUSIONS: Selected patients on chronic anticoagulant therapy can acquire a satisfactory ability for self-adjustment of OAT dose without specific training.  (+info)

(4/76) Cytochrome P4502C9 is the principal catalyst of racemic acenocoumarol hydroxylation reactions in human liver microsomes.

The oral anticoagulant acenocoumarol is given as a racemic mixture. The (S)-enantiomer is rapidly cleared and is the reason why only (R)-acenocoumarol contributes to the pharmacological effect. The objective of the study was to establish the cytochrome P450 (CYP) enzymes catalyzing the hydroxylations of the acenocoumarol enantiomers. Of various cDNA-expressed human CYPs, only CYP2C9 hydroxylated (S)-acenocoumarol. Hydroxylation occurred at the 6-, 7-, and 8-position with equal K(m) values and a ratio of 0.9:1:0.1 for V(max). CYP2C9 also mediated the 6-, 7-, and 8-hydroxylations of (R)-acenocoumarol with K(m) values three to four times and V(max) values one-sixth times those of (S)-acenocoumarol. (R)-Acenocoumarol was also metabolized by CYP1A2 (6-hydroxylation) and CYP2C19 (6-, 7-, and 8-hydroxylation). In human liver microsomes one enzyme only catalyzed (S)-acenocoumarol hydroxylations with K(m) values < 1 microM. In most of the samples tested the 7-hydroxylation of (R)-acenocoumarol was also catalyzed by one enzyme only. The 6-hydroxylation was catalyzed by at least two enzymes. Sulfaphenazole could completely inhibit in a competitive way the hydroxylations of (S)-acenocoumarol and the 7-hydroxylation of (R)-acenocoumarol. The 6-hydroxylation of (R)-acenocoumarol could be partially inhibited by sulfaphenazole, 40 to 50%, and by furafylline, 20 to 30%. Significant mutual correlations were obtained between the hydroxylations of (S)-acenocoumarol, the 7-hydroxylation of (R)-acenocoumarol, the 7-hydroxylation of (S)-warfarin, and the methylhydroxylation of tolbutamide. The results demonstrate that (S)-acenocoumarol is hydroxylated by a single enzyme, namely CYP2C9. CYP2C9 is also the main enzyme in the 7-hydroxylation of (R)-acenocoumarol. Other enzymes involved in (R)-acenocoumarol hydroxylation reactions are CYP1A2 and CYP2C19. Drug interactions must be expected, particularly for drugs interfering with CYP2C9. Also, drugs interfering with CYP1A2 and CYP2C19 may potentiate acenocoumarol anticoagulant therapy.  (+info)

(5/76) Low molecular weight heparin versus oral anticoagulants in the long-term treatment of deep venous thrombosis.

PURPOSE: The purpose of this study was to evaluate whether low molecular weight heparin (LMWH) could be equal or more effective than conventional oral anticoagulants (OAs) in the long-term treatment of deep venous thrombosis (DVT). METHODS: One hundred fifty-eight patients with symptomatic DVT of the lower limbs confirmed by means of duplex ultrasound scan were randomized to receive 3 to 6 months' treatment with nadroparine calcium or acenocoumarol. Quantitative and qualitative duplex scan scoring systems were used to study the evolution of thrombosis in both groups at 1, 3, 6, and 12 months. RESULTS: During the 12-month surveillance period, two (2.5%) of the 81 patients who received LMWH and seven (9%) of the 77 patients who received OAs had recurrence of venous thrombosis (not significant). In the LMWH group no cases of major bleeding were found, and four cases (5.2%) occurred in the OA group (not significant). The mortality rate was nine (11.1%) in the LMWH group and 7.8% in the OA group (not significant). The quantitative mean duplex scan score decreased in both groups during the follow-up and had statistical significance after long-term LMWH treatment on iliofemoral DVT (1, 3, 6, and 12 months), femoropopliteal DVT (1-3 months), and infrapopliteal DVT (first month). Duplex scan evaluation showed that the rate of venous recanalization significantly increased in the common femoral vein at 6 and at 12 months and during each point of follow-up in the superficial and popliteal veins in the LMWH group. Reflux was significantly less frequent in communicating veins after LMWH treatment (17.9% vs 32.2% in the OA group). The reflux rates in the superficial (22.4% in the LMWH group, 30.6% in OA group) and deep (13.4% vs 17.7%) venous system showed no significant differences between groups. CONCLUSIONS: The unmonitored subcutaneous administration of nadroparine in fixed daily doses was more effective than oral acenocoumarol with laboratory control adjustment in achieving recanalization of leg thrombi. With nadroparine, there was less late valvular communicating vein insufficiency, and it was at least as efficacious and safe as oral anticoagulants after long-term administration. These results suggest that LMWHs may therefore represent a real therapeutic advance in the long-term management of DVT.  (+info)

(6/76) Optimal oral anticoagulant intensity to prevent secondary ischemic and hemorrhagic events in patients after infrainguinal bypass graft surgery. Dutch BOA Study Group.

OBJECTIVES: The purpose of this study was to determine the optimal intensity of oral anticoagulation in patients who participated in a randomized trial of oral anticoagulants or aspirin after infrainguinal bypass graft surgery. METHODS: The distribution of patient-time spent in international normalized ratio (INR) classes of 0.5 INR unit was calculated assuming a linear change between successive measurements. INR-specific incidence rates of ischemic and hemorrhagic events were calculated as the ratio of the number of events at a certain INR category and the total patient-time spent in that class. The relationship between INR class and event rates was quantified by rate ratios calculated in a Poisson regression model. RESULTS: In 1326 patients (mean age, 69 years) 41,928 INR measurements were recorded in 1698 patient-years. Patients spent 50% of the total time within the target range of 3.0 to 4.5 INR. Most of the patient-time (60%) was spent between 2.5 and 3.5 INR. For each increasing class of 0.5 INR, the incidence of ischemic events (n = 154, INR data on event available in 49%) decreased by a factor of 0.97 (95% CI, 0.87-1.08). The incidence of major bleeding (n = 123, INR data on event available in 65%) increased significantly by a factor of 1.27 (95% CI, 1.19-1.34) for each increasing 0.5 INR category. The optimal target range was 3.0 to 4.0 INR, with an incidence of 3.8 events (0.9 ischemic and 2.9 hemorrhagic) per 100 patient-years. CONCLUSIONS: The target range of 3.0 to 4.0 INR is the optimal range of achieved anticoagulation intensity and is safe for the prevention of ischemic events in patients after infrainguinal bypass graft surgery.  (+info)

(7/76) Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. Warfarin Optimal Duration Italian Trial Investigators.

BACKGROUND: In patients with idiopathic deep venous thrombosis, continuing anticoagulant therapy beyond three months is associated with a reduced incidence of recurrent thrombosis during the period of therapy. Whether this benefit persists after anticoagulant therapy is discontinued is controversial. METHODS: Patients with a first episode of idiopathic proximal deep venous thrombosis who had completed three months of oral anticoagulant therapy (with warfarin, in 97 percent of the cases and acenocoumarol in 3 percent) were randomly assigned to the discontinuation of oral anticoagulants or to their continuation for nine additional months. The primary study outcome was recurrence of symptomatic, objectively confirmed venous thromboembolism during at least two years of follow-up. RESULTS: The primary intention-to-treat analysis showed that of 134 patients assigned to continued oral anticoagulant therapy, 21 had a recurrence of venous thromboembolism (15.7 percent; average follow-up, 37.8 months), as compared with 21 of 133 patients assigned to the discontinuation of oral anticoagulant therapy (15.8 percent; average follow-up, 37.2 months), resulting in a relative risk of 0.99 (95 percent confidence interval, 0.57 to 1.73). During the initial nine months after randomization (after all patients received three months of therapy), 1 patient had a recurrence while receiving oral anticoagulant therapy (0.7 percent), as compared with 11 of the patients assigned to the discontinuation of oral anticoagulant therapy (8.3 percent; P=0.003). The incidence of recurrence after the discontinuation of treatment was 5.1 percent per patient-year in patients in whom oral anticoagulant therapy was discontinued after 3 months (95 percent confidence interval, 3.2 to 7.5 percent; average interval since discontinuation, 37.2 months) and 5.0 percent per patient-year in patients who received an additional 9 months of oral anticoagulant therapy (95 percent confidence interval, 3.1 to 7.8 percent; average interval since discontinuation, 29.4 months). None of the recurrences were fatal. Four patients had non-fatal major bleeding during the extended period of anticoagulant therapy (3.0 percent). CONCLUSIONS: In patients with idiopathic deep venous thrombosis, the clinical benefit associated with extending the duration of anticoagulant therapy to one year is not maintained after the therapy is discontinued.  (+info)

(8/76) Determination of coumarin-type anticoagulants in human plasma by HPLC-electrospray ionization tandem mass spectrometry with an ion trap detector.

BACKGROUND: Coumarin-type anticoagulants are used for the long-term treatment and prevention of thromboembolic disorders. The identification of these drugs is crucial in patients with an increased prothrombin time of unknown origin. The aim of this study was to develop a sensitive and specific method for the simultaneous determination of phenprocoumon, acenocoumarol, and warfarin in human plasma by HPLC-electrospray ionization tandem mass spectrometry. METHODS: After addition of the internal standard, p-chlorowarfarin, plasma samples were extracted using Oasis MCX solid-phase extraction cartridges. The compounds were separated on a Symmetry C18 column (Waters) with a mobile phase of acetonitrile-1 g/L formic acid (75:25 by volume) at a flow rate of 0.5 mL/min. RESULTS: Extraction and separation of the three drugs and the internal standard were accomplished in 9 min. The overall extraction efficiency was >89% for all three compounds. The limits of detection were 1 microg/L for phenprocoumon and warfarin and 10 microg/L for acenocoumarol. Regression analysis of the calibration data revealed good correlation (r(2) >or=0.995) for all compounds. Within-run accuracies for quality-control samples were +/- 1% to 7% of the target concentration, with CVs <9%. CONCLUSIONS: The proposed method enables the unambiguous identification and quantification of phenprocoumon, warfarin, and acenocoumarol in both clinical and forensic specimens. This method combines a new, rapid solid-phase extraction procedure with an extremely fast chromatographic analysis, which is especially advantageous for clinical laboratories.  (+info)

*  Acenocoumarol
... is an anticoagulant that functions as a vitamin K antagonist (like warfarin). It is a derivative of coumarin and ... Drugs.com Drugs.com international listings for acenocoumarol DDB 29202 Cesar J, García-Avello A, Navarro J, Herraez M (2004). " ... Lengyel M; SPORTIF-III Altanulmány Vizsgálói (2004). "Warfarin or acenocoumarol is better in the anticoagulant treatment of ... Ufer M (2005). "Comparative pharmacokinetics of vitamin Kd antagonists: warfarin, phenprocoumon and acenocoumarol". Clin ...
*  Chlortetracycline
... may increase the anticoagulant activities of acenocoumarol. The risk or severity of adverse effects can be ...
*  Anticoagulant
Other examples are acenocoumarol, phenprocoumon, atromentin, and phenindione. The coumarins brodifacoum and difenacoum are used ...
*  Factor X
In some European countries, other coumarin derivatives (phenprocoumon and acenocoumarol) are used. These agents, so-called ...
*  Ofloxacin
The fluoroquinolones have been shown to increase the anticoagulant effect of Acenocoumarol, Anisindione, and Dicumarol. ...
*  Warfarin
... such as acenocoumarol and phenprocoumon. These have a shorter (acenocoumarol) or longer (phenprocoumon) half-life, and are not ...
*  Vitamin K antagonist
Warfarin (Coumadin) Coumatetralyl Phenprocoumon Acenocoumarol Dicoumarol Tioclomarol Brodifacoum Another group of VKAs are 1,3- ...
*  Des-gamma carboxyprothrombin
A 1987 report described the use of DCP determination in the detection of intoxication with acenocoumarol, a vitamin K ...
*  Coagulation
... is pharmacologically important as a target of anticoagulant drugs warfarin and related coumarins such as acenocoumarol, ...
*  Verification and validation
2008). "Improvement in the regulation of the vitamin K antagonist acenocoumarol after a standard initial dose regimen: ...
*  Hydroxyacetophenone
... used to make warfarin and acenocoumarol). In Ex1 of Dietifen patent, deanol ether is described. Shorthand notation is also ...
*  4-Hydroxycoumarins
Pharmaceutical examples of 4-hydroxycoumarin pharmaceuticals include: acenocoumarol dicoumarol ethyl biscoumacetate ...
*  Instituto Nacional de Medicina Genómica
... doses guided by genotype-phenotype and in their standard management in patients who initiate anticoagulation with acenocoumarol ...
*  List of MeSH codes (D03)
... acenocoumarol MeSH D03.438.150.446.520.203 --- dicumarol MeSH D03.438.150.446.520.451 --- ethyl biscoumacetate MeSH D03.438. ... acenocoumarol MeSH D03.830.219.446.520.203 --- dicumarol MeSH D03.830.219.446.520.451 --- ethyl biscoumacetate MeSH D03.830. ...
*  Edoxaban
Warfarin, phenprocoumon, and acenocoumarol are orally active vitamin K antagonists (VKA) which decrease hepatic synthesis of a ...
*  CYP2C9
... drugs with a narrow therapeutic index such as warfarin and phenytoin and other routinely prescribed drugs such as acenocoumarol ...
*  Rivaroxaban
Whereas, the orally active warfarin, phenprocoumon, and acenocoumarol are vitamin K antagonists (VKA) decrease a number of ...
*  List of drugs: Ac
... acenocoumarol (INN) Aceon aceperone (INN) Acephen acepromazine (INN) aceprometazine (INN) acequinoline (INN) acesulfame (INN) ...
*  ATC code B01
B01AA01 Dicoumarol B01AA02 Phenindione B01AA03 Warfarin B01AA04 Phenprocoumon B01AA07 Acenocoumarol B01AA08 Ethyl ...
*  Pulmonary embolism
... acenocoumarol, or phenprocoumon therapy is commenced (this may take several days, usually while the patient is in the hospital ...
*  DMOZ - Health: Pharmacy: Drugs and Medications: W: Warfarin
A free-to-use web interface that will simulate the action of oral anticoagulants such as warfarin and acenocoumarol based on ...
Reversal of anticoagulation can be needed in patients undergoing heart valve surgery. ROTEM® has been correlated with international normalized ratio (INR) in patients on warfarin but not with patients on acenocoumarol. This study investigates the reliability of ROTEM® for detecting INR values below the 1.5 threshold in patients on acenocoumarol therapy. Patients on oral anticoagulation with acenocoumarol after elective heart valve replacement were prospectively included in the study. INR and the ROTEM® were measured simultaneously. ROTEM® parameters included coagulation time, clot formation time, alpha angle, and maximal clot firmness after tissue factor activation (EXTEM). Concordance between INR and ROTEM® was analyzed by Lins concordance coefficient (LCC) and the correlation with Spearmans rho. Fifty-four consecutive patients (40 female; median age 67years) were included. Clotting time (CT) was the parameter that best correlated with INR (r=0.81, ...
OBJECTIVE: The aim of this study was to investigate the respective contribution of the different cytochrome P450 (CYP) 2C9 genetic polymorphisms to the interindividual variability of acenocoumarol pharmacodynamic response. METHODS: A total of 263 healthy volunteers were genotyped for CYP2C9*2, CYP2C9*3, CYP2C9*4, and CYP2C9*5 alleles, as well as for the nicotinamide adenine dinucleotide phosphate, reduced, quinone oxidoreductase 1 genetic polymorphism (NQO1*2). Moreover, the 5-flanking region of the CYP2C9 gene was investigated for new polymorphisms, and haplotype analysis was then performed. Finally, CYP2C9 phenotype was evaluated after a single oral dose of 4 mg of acenocoumarol. Factor VII coagulant activity was measured before and 24 hours after acenocoumarol intake. RESULTS: The CYP2C9*3 allele was the only nonsynonymous single nucleotide polymorphism (SNP) influencing acenocoumarol pharmacodynamics; the percentages of remaining factor VII were 60% +/- 19%, 39% +/- 17%, and 17% for ...
... is an oral anticoagulant of the coumarin series, synthesized and developed in the Geigy laboratoires in the late 1960s and sold in the United States under the brand name of Sintrom. It lowers the prothrombin level of the blood. It is a white crystalline powder without taste and odor and has a molecular weight of 353. It is soluble in alkaline solutions but only slightly soluble in water and organic solvents. Chemically, acenocoumarol is 3-(alpha-acetonyl-4-nitrobenzyl)-4-hydroxycoumarin. ...
Listing your company for ACENOCOUMAROL (NICOUMALONE) allows buyers to find your information through our directory pages which appear in the top positions when a search is conducted in Google, Yahoo!, MSN etc ...
Listing your company for ACENOCOUMAROL allows buyers to find your information through our directory pages which appear in the top positions when a search is conducted in Google, Yahoo!, MSN etc ...
Manufacturers and Dealers Of BULK DRUGS, 3-INDANEDIONE,4-AMINO-1,2,4-TRIAZOLE,ACECLOFENAC,ACENOCOUMAROL,ACESULFAME POTASSIUM,ACTIVE PHARMACEUTICAL INGREDIENTS,ACTIVE PHARMACEUTICALS INGREDIENTS,ALBENDAZOLE IP,ALLERGY MEDICINES,ALLOXAN MONOHYDRATE, From India
In a study that our research group published recently in this journal, we demonstrated the relative safety of intra-articular injection in patients anticoagulated with acenocoumarol.1 These results agreed with those that had been previously reported for warfarin users.2,3 In the last few years, other oral anticoagulants have been made available for the secondary prevention of stroke or primary prevention of thrombotic phenomena of any type in patients in whom the anticoagulation achieved with acenocoumarol was difficult to control.4 After the experience in our registry of patients taking acenocoumarol, we reviewed our findings concerning complications following intra-articular injection of the knee and periarticular injection in shoulder in patients receiving dabigatran, a drug from a new generation of oral anticoagulants, with proven efficacy in the prevention of primary and secondary embolic events, which is especially indicated in patients in the geriatric population who have been diagnosed ...
Concomitant use of probenecid is not recommended. Probenecid decreases the renal tubular secretion of amoxicillin. Concomitant use with AUGMENTIN may result in increased and prolonged blood levels of amoxicillin but not of clavulanate. Concomitant use of allopurinol during treatment with amoxicillin can increase the likelihood of allergic skin reactions. There are no data on the concomitant use of AUGMENTIN and allopurinol. In common with other antibiotics, AUGMENTIN may affect the gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives. In the literature there are rare cases of increased international normalised ratio in patients maintained on acenocoumarol or warfarin and prescribed a course of amoxicillin. If co-administration is necessary, the prothrombin time or international normalised ratio should be carefully monitored with the addition or withdrawal of AUGMENTIN ...
The small size of the penicillins increases their potency, by allowing them to penetrate the entire depth of the cell wall. [url=http://valleyofshadowsanddreams.com/]viagra coupon[/url] The more you know about your anxiety the more you can avoid anxiety mistakes. List of excipients Citric acid anhydrous E330 Sodium Benzoate E211 Aspartame E951 Talc E553b Sodium citrate, anhydrous E331 Guar E412 Silicon dioxide, precipitated E551 Lemon flavouring, powdered Peach-apricot flavouring, powdered Orange flavouring, powdered 6. [url=http://valleyofshadowsanddreams.com/]viagra online[/url] However, in the literature there are cases of increased international normalised ratio in patients maintained on acenocoumarol or warfarin and prescribed a course of amoxicillin.. ...
The increase in oral anticoagulant (OA) treatment has led to development of new strategies for its control. We tested the efficacy of the GAO software (Dade Behring) in providing adequate acenocoumaro
Buy Generic Benicar Online Buy Without Prescription Cheap. Buy Generic Benicar Online Free Airmail Or Courier Shipping, Free Courier Delivery, We Accept Visa, Mastercard, Amex, Diners
MedicScientist is provided for information purposes only and should not be used as a substitute for evaluation and treatment by a physician. Terms of Use. Poward ByAceDesigno. ...
There are none...: Even the strongest opiates only "take the edge off" for people in chronic pain. Meds are only one part of dealing with the pain. A useful tool, but pain is so necessary for survival that we are not "allowed" to monkey with it much. In acute pain, the transition from miserable to less miserable can be great. In chronic pain, its just part of the plan. ...Read more ...
Proportions of patients who will achieve Recanalization of thrombus (complete i.e No thrombus is seen or partial i.e up to 50% of the lumen become patent.)on oral anticoagulant acenocoumarol during the study period of 2 year from randomization ...
Coumarins are widely prescribed worldwide, and in Mexico acenocumarol is the preferred form. It is well known that despite its efficacy, coumarins show a high variability for dose requirements. We investigated the pharmacogenetic variation of 110 genes in patients receiving acenocumarol using a targeted NGS approach. We report relevant population differentiation for variants on CYP2C8, CYP2C19, CYP4F11, CYP4F2, PROS, and GGCX, VKORC1, CYP2C18, NQO1. A higher proportion of novel-to-known variants for 10 genes was identified on 41 core pharmacogenomics genes related to the PK (29), PD (3), of coumarins, and coagulation proteins (9) including, CYP1A1, CYP3A4, CYP3A5, and F8, and a low proportion of novel-to-known variants on CYP2E1, VKORC1, and SULT1A1/2 ...
Coumarins are widely prescribed worldwide, and in Mexico acenocumarol is the preferred form. It is well known that despite its efficacy, coumarins show a high variability for dose requirements. We investigated the pharmacogenetic variation of 110 genes in patients receiving acenocumarol using a targeted NGS approach. We report relevant population differentiation for variants on CYP2C8, CYP2C19, CYP4F11, CYP4F2, PROS, and GGCX, VKORC1, CYP2C18, NQO1. A higher proportion of novel-to-known variants for 10 genes was identified on 41 core pharmacogenomics genes related to the PK (29), PD (3), of coumarins, and coagulation proteins (9) including, CYP1A1, CYP3A4, CYP3A5, and F8, and a low proportion of novel-to-known variants on CYP2E1, VKORC1, and SULT1A1/2 ...
Differences in relevance from the obtainable MedChemExpress GDC-0853 pharmacogenetic data, additionally they indicate variations inside the assessment from the
In April 2003, Janet Woodcock, MD, the director of the FDAs Center for Drug Evaluation and Research, told an agency committee that the time had arrived to incorporate pharmacogenetic data in drug labels.
The maximum sample volume was calculated for a range of separation ratio values (a) and capacity ratio values (k) for the first eluted peak. The results are shown in figure 2.. ...
Looking for online definition of acenocoumarol in the Medical Dictionary? acenocoumarol explanation free. What is acenocoumarol? Meaning of acenocoumarol medical term. What does acenocoumarol mean?
The aim of the study is to explore the contribution of genetic factors related either to drug metabolism (cytochrome P450 2C9) or to drug target (vitamin K epoxide reductase) to variability in the response to acenocoumarol among 222 healthy volunteers after a single oral dose. Associations between a pharmacodynamic index (reduction in factor VII activity and international normalized ratio [INR] change) and several genetic polymorphisms (VKORC1: -4931T,C, -4451C,A, -2659G,C, -1877A,G, -1639G,A, 497C,G, 1173C,T, and CYP2C9*3) were investigated using haplotype and univariate analyses. VKORC1 haplotypes were associated with the pharmacologic response, and this association can be explained only by the effect of the -1639G,A polymorphism (or alternatively by 1173C,T, which is in complete association with it). Indeed, it explains about one third of the variability of the pharmacologic response (37% of factor VII decrease and 30% of INR change). Moreover, the previously observed effect of the CYP2C9*3 ...
Secondly, the type of vitamin K antagonist used may be of importance. In the trial by Sconce et al. all patients used warfarin while in the trial by Rombouts et al. all patients were on phenprocoumon. In our trial most patients were using phenprocoumon and a small number of patients used acenocoumarol. These three vitamin K antagonists have different half-lives and previous studies showed that the stability of anticoagulant therapy was better with the longer-acting phenprocoumon than with acenocoumarol.15-19 A recent study showed better stability in patients treated with warfarin than in patients using phenprocoumon.22 We performed a subgroup analysis in the group of patients treated with acenocoumarol. The difference became more marked between the placebo group and the vitamin K1 150 μg group, but with wide confidence intervals due to the small number of acenocoumarol users (9.5% difference in TTR; 95% CI: −61.8% - 80.9%). After pooling all three vitamin K1 groups for the acenocoumarol users ...
Rationale:. The narrow therapeutic range and wide inter-patient variability in dose requirement make anticoagulation response to coumarin derivatives unpredictable. As a result, patients require frequent monitoring to avert adverse effects and maintain therapeutic efficacy. Polymorphisms in cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase complex 1 (VKORC1) jointly account for about 40% of the inter-individual variability in dose requirements. To date, several pharmacogenetic guided dosing algorithms for coumarin derivatives, predominately for warfarin, have been developed. However, the potential benefit of these dosing algorithms in terms of their safety and clinical utility has not been adequately investigated in randomised settings. Objective: To determine whether a dosing algorithm containing genetic information increases the time within therapeutic INR range during anticoagulation therapy with each of warfarin, acenocoumarol and phenprocoumon compared to a dosing regimen that ...
Discontinuation of OAC between weeks 6 and 12 and replacement by adjusted-dose unfractionated heparin (a PTT ≥2× control; in high-risk patients applied as intravenous infusion) or low molecular weight heparin twice daily (with dose adjustment according to weight and target anti-Xa level 4-6 hours post-dose 0.8-1.2 U/mL) should be considered in patients with a warfarin dose required of ,5 mg/day (or phenprocoumon ,3 mg/day or acenocoumarol ,2mg/day). [Recommendation Class IIa Level of evidence C ...
Anticoagulants are medicines that prevent the blood from clotting as quickly or as effectively as normal. Some people call anticoagulants blood thinners. However, the blood is not actually made any thinner - it just does not clot so easily whilst you take an anticoagulant.. Anticoagulants are used to treat and prevent blood clots that may occur in your blood vessels. Blood clots can block blood vessels (an artery or a vein). A blocked artery stops blood and oxygen from getting to a part of your body (for example, to a part of the heart, brain or lungs). The tissue supplied by a blocked artery becomes damaged, or dies, and this results in serious problems such as a stroke or heart attack. A blood clot in a large vein, such as a clot in a leg vein (a deep vein thrombosis), can lead to serious problems. For example, it can lead to a clot that travels from the leg vein to the lungs (a pulmonary embolism).. A number of anticoagulants are available, including warfarin, acenocoumarol, phenindione, ...
Cytochrome P450 2C9 (abbreviated CYP2C9) is an enzyme that in humans is encoded by the CYP2C9 gene. CYP2C9 is an important cytochrome P450 enzyme with a major role in the oxidation of both xenobiotic and endogenous compounds. CYP2C9 makes up about 18% of the cytochrome P450 protein in liver microsomes (data only for antifungal). Some 100 therapeutic drugs are metabolized by CYP2C9, including drugs with a narrow therapeutic index such as warfarin and phenytoin and other routinely prescribed drugs such as acenocoumarol, tolbutamide, losartan, glipizide, and some nonsteroidal anti-inflammatory drugs. By contrast, the known extrahepatic CYP2C9 often metabolizes important endogenous compound such as serotonin and, owing to its epoxygenase activity, various polyunsaturated fatty acids, converting these fatty acids to a wide range of biological active products. In particular, CYP2C9 metabolizes arachidonic acid to the following eicosatrienoic acid epoxide (termed EETs) stereoisomer sets: ...
Background The indications for continuous oral anticoagulant treatment, the target interval and the procedures for withdrawing treatment have changed in the last 10 years.
[125 Pages Report] Check for Discount on Global Oral Anticoagulants Sales Market Report 2016 report by QYResearch Group. Notes: Sales, means the sales volume of Oral Anticoagulants Revenue,...
Direct oral anticoagulants (DOACs) have distinct bleeding profiles and require individualized management approaches, according to a new review.
This report studies Oral Anticoagulants in Global market, especially in North America, Europe, China, Japan, Southeast Asia and India, focuses on top manuf
Alpha San Ignacio Pharma is an early stage NanoBio Chip company, positioned to deliver a scalable sensor platform to the Molecular Diagnostics world. His first market for 4 year firs roll up phase is the anticoagulants treatment market. Oral Anticoagulants Treatments (in Spanish TAO, tratamientos orales anticoagulantes) is a core market in the developed countries markets. Around 1-1,5% of total population is affected. Comparative studies of the state of the art on the quality of oral anticoagulant therapy reflects a disjunctive choose (warfarin versus acenocoumarol). Mechanism target of coumarin action relies on the significance of vitamin K epoxide reductase inhibition. An a general reference index INR is treated to evaluate patient evolution, however part of the internal effects interaction are a black box and are some room for improvement. Combining nanotechnology and digital signaling is possible to obtain cost and time savings advantages. Combining advances of semiconductor industry looking ...
Blood thinners basically inhibit the appearance of fibrin; they prevent thrombosis, contribute to stopping the growth of existing blood clots, enhance the effects of blood clots in the endogenous fibrinolytic enzymes.. Anticoagulants are divided into 2 groups: a) direct anticoagulants - quick action (heparin sodium, nadroparin calcium, enoxaparin sodium, etc.), efficient in vitro and in vivo; b) antiakoagulyanty indirect (vitamin K antagonists) - long-acting (warfarin, phenindione, acenocoumarol, etc.), are in vivo only after a latent period ...
Best Price for Nabumetone on the web! Nabumetone For Men Order, Order Nabumetone Market Share, Buy Nabumetone Cvs Pharmacy Tags: relafen, nabumetone.
The study indicated that, after accounting for differences in baseline characteristics, there were no apparent differences in outcomes between patients who were and were not prescribed oral anticoagulants. There was also no relationship between the CHA2DS2-VASc score and the probability that patients had filled a prescription for an oral anticoagulant, and ultimately no evidence that the CHA2DS2-VASc risk score can effectively indicate the potential benefits of systemic oral anticoagulants for patients initiating hemodialysis with preexisting Afib.. Additional research is necessary to further guide using anticoagulants in this population.. For more information, read the research poster (which was presented at ASN) here.. ...
NARCOTICS ANTITUSSIVES NIKOMETAMIDE NICOGAMOL NICOLAR NICOLET nicomethanol NICOMOL Takign NICOMORPHOLINE NICONACID NICOPHOLINE NICORANDIL NICORETTE NICOTAFURYL NICOTHIAZONE NICOTIANA NICOTIBIN NICOTIBINE Ibuprьfen NICOTINAMIDE nicotinamide-adenine-dinucleotide when taking ibuprofen after drinking phosphate NICOTINAMIDE-ASCORBATE nicotinamide-hypovitaminosis nicotinamide-mononucleotide NICOTINAMIDE-N-OXIDE NICOTINATE NICOTINATE-BENZYL nicotinate-butoxyethyl-ester NICOTINATE-BUTYL-ESTER NICOTINATE-ETHYL NICOTINATE-HEXYL nicotinate-hydrazide NICOTINATE-METHYL NICOTINATE-OCTYL Lortab felony 81 ппNICOTINE NICOTINE-N-OXIDE NICOTINE-POLACRILEX NICOTINIC nicotinic-antagonist nicotinohydroxamate nicotinolytic Ibuproefn NICOTINOYL-PROCAINE NICOTINOYLALANINE NICOTINOYLHYDRAZINE nicotinoylmorphine-3 nicotinoylmorphine-6 NICOTINOYLTRYPTAMINE-N NICOTINURATE NICOTINYL-ALCOHOL NICOTINYL-AMINONICOTINATE-6 nicotinylamidoantipyrine NICOTINYLMETHYLAMIDE nicoumalone NICOVITOL NICOX NICOXAMAT NICRAZIN NICTIAZEM NICTINDOLE
A five-year-old KwaZulu-Natal boy made history when he became the youngest person in Africa to receive a mechanical heart implantation.
Mark Crowther, MD discusses the results of various analyzes regarding the reversal of direct oral anticoagulants, including PCCs and Tailored Reversal Agents idarucizumab and andexanet alfa., TV Network
Laura Talamo, MD discusses the results of retrospective analysis of a random sample of patients prescribed direct oral anticoagulants (DOACs) for any indication from May 2011 through April 2016. , TV Network
Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants Sebastian Luger,1 Carina Hohmann,2 Daniela Niemann,1 Peter Kraft,3 Ignaz Gunreben,3 Tobias Neumann-Haefelin,2 Christoph Kleinschnitz,3 Helmuth Steinmetz,1 Christian Foerch,1 Waltraud Pfeilschifter1 1Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, 2Department of Neurology, Klinikum Fulda gAG, Fulda, 3Department of Neurology, University Hospital Würzburg, Würzburg, Germany Background: Oral anticoagulant therapy (OAT) potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA) have been the standard of care for long-term OAT for decades, but non-VKA oral anticoagulants (NOAC) have recently been approved for this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA and NOAC in secondary stroke prevention. Methods: All patients treated from October 2011 to
Moll and Ortel report that the use of the international normalized ratio (INR) to standardize prothrombin times is invalid for some patients with lupus anticoagulants, who should be individually monitored with a test that is insensitive to lupus anticoagulants [1]. Their conclusions support our suggestion that monitoring of oral anticoagulation with prothrombin time in patients with lupus anticoagulants should be performed at high plasma dilutions to avoid unnecessary excessive anticoagulation for patients who may have major bleeding complications [2]. In a series of 10 patients with persistent lupus anticoagulants and venous thromboembolic disease who had been treated with acenocoumarol for a total of 40 patient-years, we monitored INRs with a recombinant thromboplastin reagent (Recombiplastin, Ortho Diagnostic Systems, Raritan, New Jersey) and with a combined thromboplastin (Pro-IL Complex, Instrumentation Laboratory; Milano, Italy), an international sensitivity index-certified reagent that ...
292568030 - EP 1101110 A1 2001-05-23 - METHOD AND APPARATUS FOR DETERMINING ANTICOAGULANT THERAPY FACTORS - [origin: CA2339006A1] A method and apparatuses are disclosed for determining an anticoagulant therapy factor (ATF), a corrected anticoagulant therapy factor and a modifie d anticoagulant therapy factor, all selectively used for monitoring oral anticoagulant therapy to help prevent excessive bleeding or deleterious bloo d clots that might otherwise occur before, during or after surgery. The anticoagulant therapy factor, the corrected anticoagulant therapy factor, an d a modified anticoagulant therapy factor are based upon disclosed methods for determining the fibrinogen tranformation rate which, in turn, is dependent o n a maximum acceleration point for fibronogen conversion.[origin: CA2339006A1] A method and apparatuses are disclosed for determining an anticoagulant therapy factor (ATF), a corrected anticoagulant therapy factor and a modifie d anticoagulant therapy factor, all selectively used
Copyright in the material you requested is held by the American Society of Mechanical Engineers (unless otherwise noted). This email ability is provided as a courtesy, and by using it you agree that you are requesting the material solely for personal, non-commercial use, and that it is subject to the American Society of Mechanical Engineers Terms of Use. The information provided in order to email this topic will not be used to send unsolicited email, nor will it be furnished to third parties. Please refer to the American Society of Mechanical Engineers Privacy Policy for further information ...
Innohep: Tinzaparin belongs to the class of medications called low-molecular-weight heparins. Tinzaparin is an antithrombotic and anticoagulant. Antithrombotics and anticoagulants reduce the clotting ability of the blood in order to prevent harmful blood clots from forming in blood vessels.
Estoy de acuerdo utilizamos cookies para mejorar la experiencia de navegación del usuario y para estudiar cómo se utiliza nuestro sitio web. si navega por nuestro sitio web, estará aceptando el uso de las cookies en las condiciones establecidas en la presente política de cookies. esta política puede ser actualizada, por lo que le invitamos a revisarla de forma regular ...
We offer clinical cancer updates, treatment guidance, and research news to the oncology nursing community. Visit us often for drug therapy testing results, patient care information and more. Download our FREE app today.
... are used to help predict how an individual will respond to a particular medication. Some people respond differently to a drug than other people do; for example, they may metabolize the drug too quickly or too slowly or not at all - meaning that the drug may not be effective or it may remain in a persons system too long and lead to side effects.
At least seven Maoists and a Greyhound constable sustained injuries in an exchange of fire on the border of Andhra Pradesh-Chattisgarh states in Khammam district, police said onn Sunday.
... Beauty Drinks Report by Material, Application, and Geography - Global - Market research report and industry analysis - 10674157
The authors describe three patients who developed a blue toe syndrome after initiation of oral anticoagulant therapy. Based on these observations and data in the literature, they discuss a possible relationship. They conclude that the vascular surgeon should be aware of this possibility and that oral anticoagulants should be used very carefully in the medical management of cholesterol embolization ...
Warfarin, a vitamin K epoxide reductase inhibitor, was first approved as an oral anticoagulant medication in 1954 and was the only option for outpatient anticoagulation for decades. Clinical trials in the 1980s and 1990s demonstrated that warfarin was highly effective at preventing strokes related to AF.7-9 The combination of these trials demonstrated an impressive 62% reduction in the risk of stroke. Despite the development and proliferation of novel oral anticoagulant alternatives, warfarin use remains prevalent and complicates the management of hemorrhagic and non-hemorrhagic surgical emergencies. As recently as 2011, warfarin was one of the top 25 most commonly prescribed medications in the USA.10 Warfarin is Food and Drug Administration (FDA) approved for the management of relatively common medical problems: the prophylaxis and treatment of venous thromboembolism and the reduction of embolic risk associated with non-valvular atrial dysrhythmia, mechanical heart valves, and the sequelae of ...
Before we begin, heres a word on nomenclature. Early on, this next generation of oral anticoagulants was convincingly called NOACs (Novel Oral AntiCoagulants), but these drugs would not be novel forever. An Institute For Safe Medication Practices (ISMP) safety alert noted that "NoAC" was interpreted as "no anticoagulation" in a patient at high risk of stroke. The ISMP has designated "NoAC" a potentially dangerous abbreviation and discourages its use. The acronym DOAC for Direct-Acting Oral Anticoagulant provides a reasonably short, easily pronounced, accurately descriptive abbreviation that distinguishes the class from warfarin, which acts indirectly. Wewill use the term DOAC throughout this issue; but be aware that other acronyms (eg, TSOAC [target-specific oral anticoagulant]) are also found in the literature and may work their way into clinical practice. ...
RESULTS For VKORC−1639/1173 alleles, there were 62 (35%) patients with the combination GG/CC, 91 (51%) with GA/CT, 25 (14%) with AA/TT and 1 (1%) with AA/CT. Phenprocoumon (PC) dosage was related to VKORC polymorphism (P , 0.001) with lower doses required for AA/TT patients. Overall, there were 27 severe bleedings and 11 thromboembolic events. For GG/CC, the incidence of major bleeding events and thromboembolic events was 13 and 6%, respectively, and for AA/TT, it was 27 and 12%, respectively. Variation in international normalized ratio (INR) ,1.5 was associated with severe bleeding complications (P = 0.025) and GA/CT patients were predisposed to INR variations ,1.5 (P = 0.028). No influence of CYP2C9 polymorphism on PC dosage and anticoagulation-related complications was found ...
Abstract. A growing number of patients with an indication for stroke prevention in atrial fibrillation have kidney-, age-, or weight-related alterations in pharmacokinetics that affect dosing of direct oral anticoagulants. Because these patients were excluded from or comprised a small number of patients in clinical trials, there is a lack of evidence to guide clinicians. As a consequence, many patients do not receive oral anticoagulation despite a high risk for atrial fibrillation-related stroke. Here, we present a review of direct oral anticoagulant pharmacokinetics and a review of the available clinical evidence in patients with weight-, kidney-, and age-related disease.. ...
What are the options?. For stable outpatients starting anticoagulant therapy, the two most common options for oral therapy would be Warfarin (bridged with 5-7 days of Low Molecular Weight Heparin subcutaneous injections) or a Direct Oral Anticoagulant (Dabigatran, Rivaroxaban, or Apixaban). Most articles written about oral anticoagulant therapy for VTE over the past 5 years have some iteration of a table describing the properties of the DOACs (this is a good example here) 1.. A few other factors help determine whether your patient is a good candidate for a DOAC 2:. ...
article{7ff7dbae-ca02-46c2-9ad0-16c3d84e5fa5, abstract = {Early or delayed onset of oral anticoagulant therapy in patients with acute ischemic stroke with atrial fibrillation is an unsolved issue. Retrospectively, 294 patient records at two hospitals were scrutinized according to a protocol consisting of 20 items regarding choice of therapy (warfarin or NOAC), time for onset of therapy, CT findings of bleeding, capacity to swallow, and occurrence of clinical deterioration during the acute phase. Out of 249 patients who survived the acute phase, 116 (47%) patients were given a new prescription of warfarin or NOAC at discharge, while 43 (17 %) continued with anticoagulant therapy already prescribed before the onset of stroke. The median value for new prescriptions in relation to stroke admission was 5 days. The pattern was similar for warfarin and NOAC. Patients in whom anticoagulant therapy was started early were characterized by good capacity to swallow and no signs of bleeding on initial CT. ...
Although the target specific oral anticoagulants (TSOAC) have been validated in clinical trials and approved for several years in the U.S., high level data regarding certain aspects of their use are lacking. As a result, clinicians have had to look to low level reports, expert opinion and pharmacokinetic information for guidance in situations such as bleeding and perioperative management. Because the experience has grown and opinions change this has been a moving and controversial target. Keeping up with continuously evolving recommendations has been a challenge. Thus it is appropriate to revisit the topic of perioperative management ...
The new oral anticoagulants carry on to achieve extra indications from the FDA. Earlier these days Boehringer Ingelheim announced that the FDA had accredited
OBJECTIVE To improve the standard of managing anticoagulant treatment and provide a basis for therapeutic quality control. DESIGN Implementation of a comprehensive computerised system for decision support. SETTING Three anticoagulation clinics in South Warwickshire. SUBJECTS Patients in South Warwickshire receiving anticoagulant treatment from September 1988 to March 1989. MAIN OUTCOME MEASURE International normalised ratio was measured and recorded at each visit. RESULTS 688 Patients visits were analysed statistically, and a 38% improvement was achieved in the results of international normalised ratios falling within the recommended therapeutic ranges of the British Society for Haematology. CONCLUSIONS The implementation of a computerised anticoagulation support system resulted in better management of patients. The system provides a basis for uniform management of treatment and a common platform for national or international trials.
Texas Childrens Hospital has become the first paediatric hospital in the US to discharge a child while on an intracorporeal ventricular assist device (VAD).
Pt had a critical lab value of INR... 5.4 I believe. Does a bolus of NS help decrease this value? If not, what is usually ordered? Thanks.
There is high incidence of rheumatic valvular heart disease in developing countries like Bangladesh, for which large number of young females undergo valve replacement with mechanical prosthetic heart valve. Pregnancy with mechanical heart valve carri
Before we begin, heres a word on nomenclature. Early on, this next generation of oral anticoagulants was convincingly called NOACs (Novel Oral AntiCoagulants), but these drugs would not be novel forever. An Institute For Safe Medication Practices (ISMP) safety alert noted that "NoAC" was interpreted as "no anticoagulation" in a patient at high risk of stroke. The ISMP has designated "NoAC" a potentially dangerous abbreviation and discourages its use. The acronym DOAC for Direct-Acting Oral Anticoagulant provides a reasonably short, easily pronounced, accurately descriptive abbreviation that distinguishes the class from warfarin, which acts indirectly.8 We will use the term DOAC throughout this issue; but be aware that other acronyms (eg, TSOAC [target-specific oral anticoagulant]) are also found in the literature and may work their way into clinical practice. ...
48 th Annual Meeting Terminology Non-VKA Oral Anticoagulants: Prevention & Treatment of Bleeding Stacy A. Voils, PharmD, MS, BCPS Navigating the Oceans of Opportunity Target-specific oral anticoagulants
[112 Pages Report] Check for Discount on Global Oral Anticoagulants Market Research Report 2016 report by QYResearch Group. Notes: Production, means the output of Oral Anticoagulants Revenue, means...
Low-molecular-weight heparins (LMWHs) accumulate in patients with impaired renal function. As this accumulation depends on heparin chain length and subsequent reticulo-endothelial/renal elimination, LMWHs might have different pharmacodynamic profiles. The primary objective was to examine if any accumulation effect of two LMWHs, enoxaparin and tinzaparin, occurred after repeated administration of a prophylactic dose over eight days in elderly patients (age |75 years) with creatinine clearance between 20 and 50 ml/min and body weight |65Kg. Patients were openly randomized to two groups (enoxaparin 4,000 IU or tinzaparin 4,500 IU once daily). Anti-Xa was measured on day 1 and day 8. Blood samples were taken at 0, 2, 4, 5, 6, 9, 12, 16 and 24 hours. The primary end point was the accumulation factor calculated as a ratio between the maximal anti-Xa activity on day 1and day 8. Fifty-five patients were included (mean age 87.9 +/- 5.5). The creatinine clearance was 34.7 +/- 11.4 ml/min; the body weight was 52.3
Cephalosporins and Warfarin and other oral anticoagulants : Medicaments, preparation prescriptions, order, dose, side effects, information, notice, pharma
Published on 1/1/2006. Yin W, Krukenkamp IB, Saltman AE, Gaudette G, Suresh K, Bernal O, Jesty J, Bluestein D. Thrombogenic performance of a st. Jude bileaflet mechanical heart valve in a sheep model. ASAIO J. 2006 Jan-Feb; 52(1):28-33. PMID: 16436887.. Read at: PubMed ...
As this page from the eMedTV site explains, an INR value of 2 or 3 is typically an appropriate range for people taking blood-thinning medications. This article explains what an INR test is and describes what may happen if the value is too high or too low.
Using a patients genotype to guide the initial dosing of warfarin or its analogues does not appear to be better than dosing based on clinical characteristics, a meta-analysis showed.
Dangerous internal bleeding can occur as a result of dalteparin drug interactions. To help avoid problems, this eMedTV page provides a list of drugs that cause negative reactions with dalteparin, as well as information on the problems that can occur.
... are important figures that help doctors determine the ability of a persons blood to clot. The standard values of PT INR may vary from
3.3.co;2-k. Can, N O; Tuncel, M; Aboul-Enein, H Y (2003). "Determination of nabumetone in pharmaceutical formulation by flow injection analysis (FIA) with UV-detection". Pharmazie. 58: 22-24. PMID 12622247. Mikami, E; Goto, T; Ohno, T; Matsumoto, H; Nishida, M (2000). "Simultaneous analysis of naproxen, nabumetone and its major metabolite 6-methoxy-2-naphthylacetic acid in pharmaceuticals and human urine by high-performance liquid chromatography". J Pharm Biomed Anal. 23: 917-925. doi:10.1016/s0731-7085(00)00365-4. Kobylińska, Kamila; Barlińska, Małgorzata; Kobylińska, Maria. "Analysis of nabumetone in human plasma by HPLC. Application to single dose pharmacokinetic studies". J Pharm Biomed Anal. 2003 (32): 323-328. doi:10.1016/S0731-7085(03)00078-5. Nobilis, M; Kopecký, J; Kv, Tina J; Svoboda, Z; Pour, M; Kune, J; Hol, Apek M; Kolá, Ová L (2003). "Comparative biotransformation and disposition studies of nabumetone in humans and minipigs using high-performance liquid chromatography with ...
Antithrombotic medications reduce thromboembolic events by inhibiting platelet aggregation and coagulation. Antiplatelet drugs and oral anticoagulants are examples of antithrombotic medications and are among the most commonly prescribed drugs in both primary and secondary care.1 Clinicians are familiar with their use, however antiplatelets and oral anticoagulants are the drug classes most commonly implicated in adverse drug reactions occurring both in the community and in hospital.23 Increasing numbers of patients have an indication for combination antiplatelet and oral anticoagulant therapy. For example, more than one million people in the UK have atrial fibrillation, of whom approximately one third also have an indication for antiplatelet therapy as secondary prevention.4 Despite the need to understand the balance between benefit and risk, there are limited randomised data investigating antithrombotic co-prescription. Current guidelines are therefore based on expert opinion and the ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
In the simplest of terms, St. Jude is a medical-device producer. In more complex terms, the company has four areas of focus: cardiac rhythm management (products for irregular heartbeats), cardiovascular (heart valves and repair products), atrial fibrillation (products for electrophysiology and cardiac surgery), and neuromodulation (neurostimulation products/stimulation of the spinal cord with tiny electrical impulses).. Founded in 1976 in St. Paul, Minn., as a pioneering manufacturer of bi-leaflet implantable mechanical heart valves, the companys innovative design soon became the gold standard for mechanical heart valves. With products sold in more than 100 countries today, the company splits revenues nicely, with essentially 50% coming from the U.S. and 50% from the rest of the world.. The doctor is ...
The use of oral anticoagulants is becoming increasingly common. For many years warfarin was the main oral anticoagulant available, but therapeutic options have expanded with the introduction of oral direct thrombin (dabigatran) and factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban). Management of patients taking any oral anticoagulant in the peri-procedural period poses a challenge to medical and surgical providers because of the competing risks of thrombosis and hemorrhage. Bridging therapy has been used to minimize time without anticoagulation when warfarin is interrupted for invasive procedures, but validated strategies based on high quality data are lacking. Existing data suggest that the use of bridging therapy may increase the risk of bleeding for some patients without reducing the risk of thrombosis. Clinical trials are currently under way to answer these questions. Because the half lives and time to anticoagulant activity of newer oral anticoagulants are shorter than for ...
Asking patients to discontinue these blood-thinning medications before any dental work is not a prudent thing to do," he stated. "The implications of discontinuing these prescriptions are greater than any postoperative bleeding complications that we get.". While patients who are only on warfarin are at minimal risk, the researchers considered other variables in their study and noted an area of greater concern.. "What we found was that individuals who were on several blood thinners, not just warfarin, were the ones who were at higher risk," Dr. Napenas said.. International normalized ratio. He and his colleagues used the CoaguChek system (Roche Diagnostics) to ascertain each patients international normalized ratio (INR), a commonly used metric when monitoring oral anticoagulant therapy and for warfarin dosage planning. Typical INR for those not on warfarin is 1; it ranges from 2 to 4 for those on the drug, with some variation based on the patients need for it, according to the study ...
OXFORD, England - Patients on oral anticoagulant therapy who self-monitor their prothrombin time with hand-held devices and adjust the dose on their own have lower rates of death and thromboembolism,
Starting warfarin means you need to return to your hospital or clinic for frequent blood tests, often 2-3 times per week for the first few weeks. More frequent blood draws are common until the dose for you is determined. Four to six weeks to find a patients proper dose is common. Patients who have received a mechanical heart valve have shown a short-term increased response to lower doses of warfarin following surgery.4. Good news may be on the way. While Medicare covers the cost of self-testing - it does not include the first 90 days, the three months when many patients have poor control of warfarin and side effects occur.. A 2012 study found that patient self-testing that began while patients were still in the hospital (following surgery) did better than patients who did not self test.5 Authors found patients spent more time in their therapeutic range than patients required to visit their clinic or return to the hospital for INR testing. Self-testing presents a less burdensome method of ...
BC: He has crossed over from death to life. John 5:24b. FC: Caring Bridge , July 8-23, 2011. 1: Our story begins on July 8, 2011. After thinking Harlan had the flu for two days and deciding that something else was going on we took him to the local ER. Later that evening they transferred him to the Avera Heart Hospital in Sioux Falls, SD. After two days of testing they diagnosed him with MRSA, which is a blood infection that turned septic. Complications that have come with that are: congestive heart failure, kidney damage and pneumonia. One of the biggest concerns for Harlan is his mechanical heart valve that he had put in 20 years ago and that the MRSA may attack this valve.. 2: Sunday, July 17, 2011 10:36 PM A week of testing has gone by with many ups and downs and there are still so many unknowns. Harlans kidneys are functioning better than they were but not at 100% yet, the extent of damage done is unsure. Yesterday he had a great morning with a walk in the halls, but by dinner time his ...
AccessGUDID - SJM™ Masters Series Hemashield™ (05414734006507)- St. Jude Medical Valved Graft Rotatable Mechanical Heart Valve
Atrial fibrillation has the highest prevalence in the elderly. While the elderly are at the highest risk for stroke and would benefit the most from anticoagulation, they are also the least likely to receive anticoagulation. In a pooled analysis of th
Tips for anticoagulated patient: Oral anticoagulants are indicated in the long-term prevention of thromboembolic disease. Anticoagulated patient is ...
Warfarin has remained a top drug therapy for the prevention of stroke for decades, but recent advancements in oral anticoagulants may provide more effective and safer treatment options.
In primary care patients in the UK, do the QBleed algorithms, based on routinely collected data, predict risk for upper gastrointestinal (GI) and intracranial bleeding in those who are and are not prescribed oral anticoagulants ...
The retroperitoneal hematoma can have, mainly, a traumatic etiology - blunt abdominal trauma (falls from height, road accidents, aggression of any kind, etc.), or open (incised wounds, puncture, penetration or gunshot wounds). Ruptured arterial aneurysms can cause hemorrhage in the retroperitoneal space. There is also spontaneous retroperitoneal trauma in patients with chronic treatment with anticoagulant or antiaggregant drugs (1). Hemorrhage in the retroperitoneal space can be iatrogenic, after surgical, open or laparoscopic, interventions (2, 3). A particular type of retroperitoneal hematoma is the psoas muscle hematoma in patients with chronic oral anticoagulant treatment (Acenocumarol, Warfarin).
Second, except for patients who have bileaflet mechanical aortic valvesand do not have atrial fibrillation, the recommended target INR range for patients with mechanical heart valves (2.5-3.5) is higher than the corresponding target INR range for the treatment of acute venous thromboembolism (2.0-3.0), suggesting that more intense antithrombotic therapyis appropriate.Further, although warfarin, with a target INR of 2.0 to 3.0, is highly effective in the long-term treatment of acute venous thromboembolism, even with the use of a more intense warfarin regimen (INR of 2.5-3.5), theaddition of aspirin to the warfarin regimen improves efficacy for patients with mechanical heart valves (albeit at the cost of an increase in the rate of minor bleeding).Given this information, we recommend that if subcutaneous UFH is used to prevent thrombosis in pregnant women with mechanical heart valves, the starting dose should be high(17500-20000 U every 12 hours) and adjusted aggressively to achieve a mid-interval ...
The 2012, European Society of Cardiology guidelines for the management of AF recommend the "new (or non-VKA) oral anticoagulants," or NOACs, as broadly preferable to VKAs in the vast majority of patients with nonvalvular AF.28 The American College of Chest Physicians Guidelines and the Canadian Cardiovascular Society Guidelines took a similar approach.29-30 Today, deciding on the optimal oral anticoagulant is rather challenging. The absence of head-to-head trials precludes firm conclusions as to which NOAC is best. However, dabigatran etexilate at the dosage of 150 mg BID along with apixaban 5 mg or 2.5 mg BID and edoxaban 60 mg once daily are the only NOACs that reduce stroke or systemic embolism in prospective phase III RCT, which is the gold standard for recommendations with respect to clinical use.4,25,31-32 Nonetheless, whatever is the indication, patients treated with NOACs may present with comorbidities such as coronary disease. In the RE-LY study, a nonsignificant but small numerical ...
Intracranial hemorrhage (ICH) is the most feared and devastating complication of oral anticoagulant therapy. When an ICH occurs, the patients situation hinges on the balance between how great is the embolic risk while not receiving anticoagulants, and how big is the threat of the hemorrhage if the anticoagulant effect is not reversed promptly. Although several studies which compared the use of different reversal agents failed to demonstrate any improvement in prognosis and survival, at the present moment the consensus seem to be that anticoagulation should be rapidly reversed after an ICH. The second question to be answered is whether and when should be oral anticoagulation treatment restarted. Although the risk of thromboembolism in patients off anticoagulation seems to be higher than the risk of ICH recurrence, there is a marked paucity of prospective large studies on the real risk of ICH recurrence when OAC is resumed, paucity that probably emphasizes the ethical challenge of prescribing ...
Comparative Effectiveness of Warfarin and Newer Oral Anticoagulants for the Long-Term Prevention and Treatment of Arterial and Venous Thromboembolism [Internet ...
Only 53.0% of patients in the study at high risk of stroke were using oral anticoagulants. This proportion increased only slightly in the years 2007-2010. At the same time, higher than expected usage was found in the low-risk groups: 32.1% of people with CHADS2 = 0 and 23.0% with CHA2DS2VASc = 0. While anticoagulation may be appropriate for some of these individuals (for example, those with valvular disease), this suggests that use of these algorithms has still to become established. CHADS2 was first proposed over a decade ago, while CHA2DS2-VASc was introduced much more recently.. The estimated high-risk population increases when more inclusive definitions of hypertension are used. The authors considered the safest to be C, which increases the proportion identified from 56.9% to 65.9%. The additional inclusion of those with raised blood pressure levels (definition D) may be unreliable, particularly given the recent emphasis on home, rather than office-based measurements for diagnosis.23 About ...
The possibility that a hypercoagulable state (thrombotic rebound) may follow anticoagulant therapy1 continues to arouse interest. In a group of patients with various disorders thrombo-embolic complications occurred particularly in the first month after stopping the anticoagulant for three days or more because of bleeding, but were distributed randomly over many months when therapy was withdrawn permanently for other reasons.2 In another study, in patients with non-haemorrhagi strokes due to cerebrovascular disease, the incidence of further non-fatal attacks was significantly increased after gradual withdrawal of anticoagulants over one month,3 although comparison with a control group showed that anticoagulants were quite ineffective in preventing such recurrences.4 5 On the other hand no withdrawal effect was found in two studies of patients with ischaemic heart disease,6 7 or in the incidence of venous thrombosis in a series of injured persons.8. ...
Nycoplastin Nycoplastin is a plain prothrombin time (PT) reagent according to the method of Quick. The reagent is lyophilized and contains rabbin brain thromboplastin added calcium.. Nycoplastin is sensitive to the depression of factors II, V, VII, X and fibrinogen but intensitive to heparin. Nycoplastin is a low ISI-reagent with an ISI of about 1.2. Nycoplastin can be used both as a screening test for the extrinsic coagulation system, as a liver function test and for control of oral anticoagulant therapy.. ...
in Stony Brook. My research is focused on numerical simulations of blood flow through mechanical heart valves and stenossed blood vessels looking at platelet activation due to flow stresses. We use CFD to solve the flow problem and some post processing techniques to calculate the platelet damage accumulation. The CFD (computational fluid dynamics) code we use in the lab is finite element based code called FIDAP (Fluent Inc.). ...
Shop Vitamin K epoxide reductase complex ELISA Kit, Recombinant Protein and Vitamin K epoxide reductase complex Antibody at MyBioSource. Custom ELISA Kit, Recombinant Protein and Antibody are available.
Warfarin is an oral anticoagulant used for prevention of thromboembolism in children. Its dosing is difficult due to the narrow therapeutic index & individual variability in effective dosage. Genetic polymorphism in 2 enzymes involved in warfarin metabolism, vitamin K epoxide reductase (VKORC) & cytochrome P450 isoenzyme 2C9 (CYP2C9), have been associated with lower dose requirements in adults. Testing for these polymorphisms is now recommended and being performed to guide dosing in adult patients(pts). Currently there is no information available on these polymorphisms & warfarin dosing in children. To examine the relationship between warfarin dosing & polymorphisms of CYP2C9 & VKORC1 in pediatric patients. Pts 0 -18 years old on warfarin for minimum 2 weeks were included. Data included ethnicity, age, weight, body surface area, gender, indication, dose, INR, target INR, medical illness or medications & adverse effects. Blood sample tested for CYP2C9 & VKORC1 genotypes & correlated with above ...
Acenocoumarol - Wikipedia  Acenocoumarol - Wikipedia
Acenocoumarol is an anticoagulant that functions as a vitamin K antagonist (like warfarin). It is a derivative of coumarin and ... Cesar J, García-Avello A, Navarro J, Herraez M (2004). "Aging and oral anticoagulant therapy using acenocoumarol". Blood Coagul ... Lengyel M; SPORTIF-III Altanulmány Vizsgálói (2004). "Warfarin or acenocoumarol is better in the anticoagulant treatment of ... Ufer M (2005). "Comparative pharmacokinetics of vitamin Kd antagonists: warfarin, phenprocoumon and acenocoumarol". Clin ...
more infohttps://en.m.wikipedia.org/wiki/Acenocoumarol
Acenocoumarol | Memorial Sloan Kettering Cancer Center  Acenocoumarol | Memorial Sloan Kettering Cancer Center
Si es alérgico al acenocoumarol o cualquier otro componente de este medicamento. ...
more infohttps://www.mskcc.org/es/cancer-care/patient-education/acenocoumarol
acenocoumarol QuickView - Correlation Engine  acenocoumarol QuickView - Correlation Engine
Leflunomide may increase the anticoagulant effect of acenocoumarol.. Trimetrexate. The anticoagulant effect of Acenocoumarol, a ... The strong CYP1A2 inhibitor, Thiabendazole, may increase the effects and toxicity of Acenocoumarol by decreasing Acenocoumarol ... The strong CYP1A2 inhibitor, Thiabendazole, may increase the effects and toxicity of Acenocoumarol by decreasing Acenocoumarol ... Thiopental may increase the metabolism of the Vitamin K antagonist, Acenocoumarol. Acenocoumarol dose adjustment may be ...
more infohttp://www.nextbio.com/b/search/details/acenocoumarol?id=&type=
Pharmacogenetic Dosage Algorithm for Acenocoumarol - Full Text View - ClinicalTrials.gov  Pharmacogenetic Dosage Algorithm for Acenocoumarol - Full Text View - ClinicalTrials.gov
Stable treatment with acenocoumarol Patients in stable anticoagulant treatment with acenocoumarol for auricular fibrillation, ... Pharmacogenetic Dosage Algorithm for Acenocoumarol. The safety and scientific validity of this study is the responsibility of ... Genetic: Acenocoumarol A blood sample was collected for CYP2C9, VKORC1, CYP4F2, APOE and 2 variants of POR genotypes. ... Creation of a pharmacogenetic algorithm of dosage for acenocoumarol [ Time Frame: Up to 5 years ]. ...
more infohttps://clinicaltrials.gov/ct2/show/NCT03015025?term=pharmacogenomics+OR+pharmacogenetics&rank=59
EUropean Pharmacogenetics of AntiCoagulant Therapy - Acenocoumarol - Full Text View - ClinicalTrials.gov  EUropean Pharmacogenetics of AntiCoagulant Therapy - Acenocoumarol - Full Text View - ClinicalTrials.gov
Validation of the acenocoumarol EU-PACT algorithms: similar performance in the Rotterdam Study cohort as in the original study ... A randomized trial of genotype-guided dosing of acenocoumarol and phenprocoumon. N Engl J Med. 2013 Dec 12;369(24):2304-12. doi ... Long-term anticoagulant effects of the CYP2C9 and VKORC1 genotypes in acenocoumarol users. J Thromb Haemost. 2012 Apr;10(4):606 ... Evaluation of the effect of statin use on the acenocoumarol and phenprocoumon maintenance dose. Drug Metabol Drug Interact. ...
more infohttps://clinicaltrials.gov/ct2/show/NCT01119261?recr=Open&intr=%22Anticoagulants%22&rank=18
Acenocoumarol | definition of acenocoumarol by Medical dictionary  Acenocoumarol | definition of acenocoumarol by Medical dictionary
... acenocoumarol explanation free. What is acenocoumarol? Meaning of acenocoumarol medical term. What does acenocoumarol mean? ... Looking for online definition of acenocoumarol in the Medical Dictionary? ... acenocoumarol. Also found in: Encyclopedia, Wikipedia. Acenocoumarol. A fast-acting vitamin K-antagonist anticoagulant. In ... acenocoumarol. A fast-acting vitamin K-antagonist anticoagulant. acenocoumarol, acenocoumarin. a warfarin derivative used as an ...
more infohttps://medical-dictionary.thefreedictionary.com/acenocoumarol
Acenocoumarol - Wikipedia  Acenocoumarol - Wikipedia
Acenocoumarol is an anticoagulant that functions as a vitamin K antagonist (like warfarin). It is a derivative of coumarin and ... Drugs.com Drugs.com international listings for acenocoumarol DDB 29202 Cesar J, García-Avello A, Navarro J, Herraez M (2004). " ... Lengyel M; SPORTIF-III Altanulmány Vizsgálói (2004). "Warfarin or acenocoumarol is better in the anticoagulant treatment of ... Ufer M (2005). "Comparative pharmacokinetics of vitamin Kd antagonists: warfarin, phenprocoumon and acenocoumarol". Clin ...
more infohttps://en.wikipedia.org/wiki/Acenocoumarol
Acenocoumarol medication - Things You Didnt Know  Acenocoumarol medication - Things You Didn't Know
There are none...: Even the strongest opiates only "take the edge off" for people in chronic pain. Meds are only one part of dealing with the pain. A useful tool, but pain is so necessary for survival that we are not "allowed" to monkey with it much. In acute pain, the transition from miserable to less miserable can be great. In chronic pain, its just part of the plan. ...Read more ...
more infohttps://www.healthtap.com/topics/acenocoumarol-medication
An Acenocoumarol Dosing Algorithm Using Clinical and Pharmacogenetic Data in Spanish Patients with Thromboembolic Disease  An Acenocoumarol Dosing Algorithm Using Clinical and Pharmacogenetic Data in Spanish Patients with Thromboembolic Disease
The mean absolute error of the predicted acenocoumarol dose (mg/week) obtained with the pharmacogenetic algorithm was 3.63 vs. ... We ascertained the influence of clinical and genetic variables on the stable acenocoumarol dose by multiple linear regression ... and some pharmacogenetic-guided dosing algorithms for warfarin and acenocoumarol have been developed for mixed populations. We ...
more infohttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041360
Acenocoumarol: A Review of Anticoagulant Efficacy and Safety. - Semantic Scholar  Acenocoumarol: A Review of Anticoagulant Efficacy and Safety. - Semantic Scholar
Acenocoumarol is effective and safe in all age groups. It offers an advantage over warfarin in terms of better stability of ... Acenocoumarol is mono-coumarin derivative with racemic mixture of R (+) and S (-) enantiomers. Efficacy and safety of ... Due to its economic advantage acenocoumarol may be suitable oral anticoagulant for long term use in countries like India. ... acenocoumarol has been evaluated in atrial fibrillation, cardiac valve replacement, after myocardial infarction, treatment of ...
more infohttps://www.semanticscholar.org/paper/Acenocoumarol%3A-A-Review-of-Anticoagulant-Efficacy-Trailokya-Hiremath/ce2dac0e628ef259ddd80f17f18ae66f34249cfa
acenocoumarol | Ligand page | IUPHAR/BPS Guide to PHARMACOLOGY  acenocoumarol | Ligand page | IUPHAR/BPS Guide to PHARMACOLOGY
acenocoumarol ligand page. Quantitative data and detailed annnotation of the targets of licensed and experimental drugs. ... Acenocoumarol is a coumarin that is used as an anticoagulant, with actions and uses similar to warfarin. The coumarins are ...
more infohttps://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=9015
Effectiveness and safety of dabigatran versus acenocoumarol in real-world patients with atrial fibrillation  Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world' patients with atrial fibrillation
acenocoumarol after adjustment for the CHA2DS2-VASc score [hazard ratio (HR)dabigatran = 0.72, 95% CI: 0.20-2.63, P = 0.61]. ... 3.7%/year acenocoumarol-treated patients. The actual incidence rate of stroke or systemic embolism was 0.8%/year [95% ... acenocoumarol (vitamin K antagonist) in patients with atrial fibrillation (AF) in daily clinical practice. ... 4.3%/year (95% CI: 2.9-6.2) in acenocoumarol. This over 50% reduction remained significant after adjustment for the HAS-BLED ...
more infohttps://insights.ovid.com/europ/201609000/00127069-201609000-00006
Stereoselective High-Performance Liquid Chromatography Tandem Mass Spectrometry Method for Determination of R- and S...  Stereoselective High-Performance Liquid Chromatography Tandem Mass Spectrometry Method for Determination of R- and S...
... method for the determination of R-acenocoumarol and S-acenocoumarol in human plasma was developed and validated at IPRC ... The method was validated over a linear range of 0.40 - 40.00 ng/ml for R-acenocoumarol and 0.20 - 20.00 ng/ml for the S- ... The method was successfully applied for the determination of R and S-acenocoumarol in plasma samples of 28 healthy subjects who ... acenocoumarol. Method validation covered different parameters such as linearity, accuracy, precision and stability. ...
more infohttp://scirp.org/journal/paperabs.aspx?paperid=53725
Acenocoumarol  Acenocoumarol
Chemically, acenocoumarol is 3-(alpha-acetonyl-4-nitrobenzyl)-4-hydroxycoumarin.. Indications. Acenocoumarol is indicated in ... Acenocoumarol is an oral anticoagulant of the coumarin series, synthesized and developed in the Geigy laboratoires in the late ...
more infohttp://science-naturalphenomena.blogspot.com/2014/03/acenocoumarol.html
Reliability of thromboelastometry for detecting the safe coagulation threshold in patients taking acenocoumarol after elective...  Reliability of thromboelastometry for detecting the safe coagulation threshold in patients taking acenocoumarol after elective...
Acenocoumarol Aged Anticoagulants Drug Administration Schedule Drug Monitoring Drug Tolerance Elective Surgical Procedures ... Patients on oral anticoagulation with acenocoumarol after elective heart valve replacement were prospectively included in the ... Reliability of thromboelastometry for detecting the safe coagulation threshold in patients taking acenocoumarol after elective ... Reliability of thromboelastometry for detecting the safe coagulation threshold in patients taking acenocoumarol after elective ...
more infohttp://www.nextbio.com/b/search/article.nb?id=26232350
Stereoselective High-Performance Liquid Chromatography Tandem Mass Spectrometry Method for Determination of R- and S...  Stereoselective High-Performance Liquid Chromatography Tandem Mass Spectrometry Method for Determination of R- and S...
The method was validated over a linear range of 0.40 - 40.00 ng/ml for R-acenocoumarol and 0.20 - 20.00 ng/ml for the S- ... The method was successfully applied for the determination of R and S-acenocoumarol in plasma samples of 28 healthy subjects who ... acenocoumarol. Method validation covered different parameters such as linearity, accuracy, precision and stability. ... method for the determination of R-acenocoumarol and S-acenocoumarol in human plasma was developed and validated at IPRC ...
more infohttp://file.scirp.org/Html/4-2201103_53725.htm
Buy cheap acenocoumarol  Buy cheap acenocoumarol
Acenocoumarol for men, acenocoumarol brand name, acenocoumarol cream and acenocoumarol alpharma or acenocoumarol prices. ... acenocoumarol side effects, acenocoumarol ingredients, discount acenocoumarol and acenocoumarol online. ... Acenocoumarol prices. Acenocoumarol alternative, acenocoumarol side effects, acenocoumarol ingredients, discount acenocoumarol ... Acenockumarol for men, acenocoumarol brand name, acenocoumarol cream and acenocoumarol alpharma or acenocoumarol prices. ...
more infohttp://cheap-now.tripod.com/acenocoumarol.html
Acenocoumarol | LGM Pharma  Acenocoumarol | LGM Pharma
Acenocoumarol inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K ... Acenocoumarol inhibits the reduction of vitamin K by vitamin K reductase. This prevents carboxylation of certain glutamic acid ... Both the extrinsic (via factors VII, X and II) and intrinsic (via factors IX, X and II) are affected by acenocoumarol. ... LGM Pharma is a Acenocoumarol CAS# 152-72-7 API supplier distributor based in the USA. Inquire about DMF, cGMP, price, ...
more infohttps://lgmpharma.com/product/acenocoumarol/
Acenocoumarol | MedicScientist :: Total Health Portal  Acenocoumarol | MedicScientist :: Total Health Portal
Details About Generic Salt :: Acenocoumarol Main Medicine Class:: Hematological System Sub Medicine Class :: Anti Coagulants. ... 1 Details About Generic Salt :: Acenocoumarol *2 Main Medicine Class:: Hematological System Sub Medicine Class :: Anti ...
more infohttp://medicscientist.com/acenocoumarol
  • Your doctor will take regular blood samples and adjust your dose of acenocoumarol as necessary to make your INR fall into the range that has been shown to be effective at preventing blood clots in your particular condition. (dxline.info)
  • You will probably need your INR checking after any changes to your acenocoumarol dose, if you become ill suddenly, or if you are prescribed certain other medicines. (dxline.info)
  • A stereoselective, sensitive and rapid liquid chromatography-tandem mass spectrometry (LC-MSMS) method for the determination of R-acenocoumarol and S-acenocoumarol in human plasma was developed and validated at IPRC bioanalytical labs. (scirp.org)
  • Multivariable analysis confirmed this lower but non-significant risk in dabigatran vs. acenocoumarol after adjustment for the CHA2DS2-VASc score [hazard ratio (HR)dabigatran = 0.72, 95% CI: 0.20-2.63, P = 0. (ovid.com)
  • Acenocoumarol is used to reduce the risk of blood clots forming inside the blood vessels in conditions such as these. (dxline.info)
  • The anticoagulant effect of acenocoumarol is measured in terms of the prothombin time, which is the time taken for blood clotting to occur in a sample of blood to which calcium and a substance known as thromboplastin have been added. (dxline.info)
  • reported in 2001 the use of HPLC-UV stereoselective quantification of the R and S- acenocoumarol in human plasma after derivatization with N-carbobenzoyl-Lproline. (scirp.org)