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Apixaban is recommended by the National Institute for Health and Clinical Excellence for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation and at least one of the following risk factors: prior stroke or transient ischemic attack, age 75 years or older, diabetes, or symptomatic heart failure.
Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain. [2] Other side effects may include stomach upset, dizziness, anemia or increased blood levels of liver enzymes. [2]
A decrease in antiplatelet effect would reduce the risk of bleeding, but increase the thromboembolic risk. [3] Drug toxicity may increase when multiple antiplatelet drugs are used. Gastrointestinal bleeding is a common adverse event seen in many patients.
This can be done using validated bleeding risk scores, such as the HEMORR 2 HAGES or HAS-BLED scores. [37] The HAS-BLED score is recommended in guidelines, to identify the high risk patient for regular review and followup and to address the reversible risk factors for bleeding (e.g. uncontrolled hypertension, labile INRS, excess alcohol use or ...
Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. [1] They are used in the prevention of blood clots and, in the treatment of venous thromboembolism (deep vein thrombosis and pulmonary embolism), and the treatment of myocardial infarction.
Enoxaparin sodium, sold under the brand name Lovenox among others, is an anticoagulant medication (blood thinner). [11] It is used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) including during pregnancy and following certain types of surgery. [ 11 ]
An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. [1] Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which help keep the bite area unclotted long enough for the animal to obtain blood.
The aim is to determine the optimal therapeutic window to maximize therapeutic benefits while reducing safety concerns like bleeding. Consequently, the major unmet goal of ADP inhibitors is to develop a potent reversible antiplatelet agent with fast onset of action, high levels of antiplatelet activity yet decreased risk of bleedings.