DARE to Prescribe: Strategy to Guide Direct Oral Anticoagulant Therapy

Hussein, Mohamed Toufic El; Cuncannon, Alexander

doi:10.1016/j.nurpra.2020.04.002

Cited by 5 publications

(13 citation statements)

References 27 publications

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“…21 Considering the pharmacokinetics of DOACs, an equally rapid anticoagulation effect can be achieved with a DOAC compared with a UFH or LMWH/fondaparinux. 22 Upon hemodynamic stabilization and reassessment of RV size, function, intracardiac thrombi determined by echocardiogram or CTPA, and fulfi lling early discharge criteria, treatment may be continued on an outpatient basis. 3 All patients with PE should be treated with anticoagulants for a minimum of 3 months.…”

Section: Classifi Cation and Initial Management Of Pe 121mentioning

confidence: 99%

“…DOACs are preferred over VKA as first-line oral anticoagulation therapy for low-risk patients as well as for intermediate- and high-risk patients once they are hemodynamically stable, unless contraindicated 21. Considering the pharmacokinetics of DOACs, an equally rapid anticoagulation effect can be achieved with a DOAC compared with a UFH or LMWH/fondaparinux 22. Upon hemodynamic stabilization and reassessment of RV size, function, intracardiac thrombi determined by echocardiogram or CTPA, and fulfilling early discharge criteria, treatment may be continued on an outpatient basis 3…”

Section: Initial Approach and Diagnosis (Chest Mnemonic)mentioning

confidence: 99%

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Hussein

Habib

2022

The Nurse Practitioner

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cute pulmonary embolism (PE) is a serious and life-threatening condition that affects about 1 to 2 in every 1,000 adults annually in Canada and the US. 1 It is the third leading cause of cardiovascular death after acute coronary syndrome and stroke. 2 The ambiguity and overlap of its presenting symptoms, such as tachycardia, dyspnea, chest pain, and syncope, make the diagnosis of PE a challenge. The mnemonic approach and treatment algorithm presented in this article will allow NPs to better manage PE by initiating appropriate and timely treatment. Current management of PE no longer requires lengthy hospital stays, if any, as treatment modalities have evolved to benefi t both the patient and the healthcare system. 1 2 to strong risk factors such as lower limb

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Section: Classifi Cation and Initial Management Of Pe 121mentioning

confidence: 99%

Section: Initial Approach and Diagnosis (Chest Mnemonic)mentioning

confidence: 99%

Chest

Hussein

Habib

2022

The Nurse Practitioner

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“…Primary nursing interventions include monitoring patients' cardiovascular and neurological status (performing neurologic vital signs), recording dysrhythmias, and notifying clinicians of any changes 37 . Nurses should review patients' medical history to determine any contraindications before initiating AC therapy, such as active or high risk of bleeding, pregnancy, breastfeeding, renal or hepatic impairment, and cerebral aneurysm 28 . Nurses should monitor platelet count and coagulation levels (INR, prothrombin time, and partial thromboplastin time), especially with warfarin, to ensure the dosing is in line with the therapeutic range.…”

Section: Nursing Implications and Management Of Patients With Lvt Rec...mentioning

confidence: 99%

“…Nurses should monitor platelet count and coagulation levels (INR, prothrombin time, and partial thromboplastin time), especially with warfarin, to ensure the dosing is in line with the therapeutic range. Anticoagulation might be paused temporarily, depending on the extent of the bleeding, while standard treatment, including reversal agents and support measures, was initiated 28 . The reinitiation of AC will depend on a risk-benefit assessment involving patients and families in the decision-making process 28 …”

Section: Nursing Implications and Management Of Patients With Lvt Rec...mentioning

confidence: 99%

“…37 Nurses should review patients' medical history to determine any contraindications before initiating AC therapy, such as active or high risk of bleeding, pregnancy, breastfeeding, renal or hepatic impairment, and cerebral aneurysm. 28 Nurses should monitor platelet count and coagulation levels (INR, prothrombin time, and partial thromboplastin time), especially with warfarin, to ensure the dosing is in line with the therapeutic range. Anticoagulation might be paused temporarily, depending on the extent of the bleeding, while standard treatment, including reversal agents and support measures, was initiated.…”

Section: Nursing Implications and Management Of Patients With Lvt Rec...mentioning

confidence: 99%

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Evidence-Based Recommendations

Hussein

Михаил

2022

Dimens Crit Care Nurs

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One of the potential complications of acute myocardial infarction is left ventricular thrombus (LVT). The incidence of LVT following acute myocardial infarction has decreased dramatically with early invasive reperfusion techniques or fibrinolysis. However, the risk of LVT formation remains significant and is associated with an increased risk of systemic embolism, stroke, cardiovascular events, and even death. Current guidelines indicate that dual antiplatelet therapy and anticoagulation therapy for at least 3 months can reduce the risk of these events. While vitamin K antagonist is the preferred oral anticoagulant, there is growing evidence to support the use of direct-acting oral anticoagulants in LVT management. Cardiac magnetic resonance has shown the highest diagnostic accuracy for LVT assessment, followed by echocardiography with contrast agents. This article serves as a general review of the pathophysiology, diagnosis, and management of LVT.

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Alphabetical Mnemonic to Assist in the Treatment of an Acute Ischemic Stroke

Hussein¹,

Green²

2021

Critical Care Nursing Quarterly

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Determining the treatment plan and how to successfully manage a patient suffering from an acute ischemic stroke can be challenging for a registered nurse (RN) in the emergency department. Using a mnemonic in the treatment process assists in reducing medical errors and increases the likelihood of making positive clinical outcomes. Mnemonics sum up complex strategies into relevant information that can be comprehensible for users. The authors have created a mnemonic strategy to provide RNs in the emergency department with a structured approach to the pharmacotherapeutic strategies used in treating patients with an acute ischemic stroke. All guidelines used throughout the article are in concurrence.

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DARE to Prescribe: Strategy to Guide Direct Oral Anticoagulant Therapy

Cited by 5 publications

References 27 publications

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Chest

Evidence-Based Recommendations

Alphabetical Mnemonic to Assist in the Treatment of an Acute Ischemic Stroke

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