COPYRIGHTED MATERIAL. Index

Transcription

1 Index A Abciximab, Abciximab in Emergency Treatment of Stroke Trial (AbESTT-II), 211 Absolute claudication distance (ACD), 62 Acetylsalicylic acid (ASA), See Aspirin Activated clotting time (ACT), 4 Activated partial thromboplastin time (aptt), 4, 117, 255 limitations, 7 8 ACUITY trial, 234 Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial, 261 Acute coronary syndrome (ACS), 49, , , See also Non-ST-elevation ACS (NSTEACS) in hospitalized patients, non-st-elevation-mi, 310 unstable angina, 310 Acute ischemic stroke management, intraarterial tpa, 209 intravenous tpa, thrombolytic therapy, Acute PE, treatment algorithm for, 143 Adenosine diphosphate (ADP), 51 American College of Chest Physicians (ACCP) guidelines, 93 94, 97, 111, , 388, ACCP guidelines, 49, , 168, atrial fibrillation management, UFH use in HIT patients, 353 for VTE prophylaxis in orthopedic surgery, in valvular heart disease management, 193 for warfarin reversal, 304 Antibody assays, enzyme immune assay (EIA), serotonin release assay (SRA), Antiphospholipid antibody syndrome (APLS), 153 Antiplatelet therapies/medications, 47 63, 156, , 206, , See also Aspirin anticoagulation therapy, 212 dual antiplatelets, intravenous, perioperative management of, continuation of antiplatelet agents, high, 172 intermediate, 172 low, 172 risk stratification, Apixaban, 67 68, 70, 74 75, 353 pharmacology, in VTE treatment, joint replacement surgery, 70 Apixaban for the prevention of thrombosis-related events (ADVANCE), 70 COPYRIGHTED MATERIAL Inpatient Anticoagulation, First Edition. Edited by Margaret C. Fang Wiley-Blackwell. Published 2011 by John Wiley & Sons, Inc. 415

2 416 Index Argatroban, 262, 265, 316, Aspirin, action mechanism, 47 adverse effects, aspirin triad, 50 contraindications, 49 dosage, 49 drug interactions, 50 effect, monitoring, 50 historical perspective, indications, 48 overdose, 51 patient questions, 48 pharmacodynamics, 48 pharmacokinetics, 48 pharmacology, preparations, 49 versus warfarin, 181 Aspirin and extended-release dipyridamole (ASA-ERDP), 217 Atherosclerosis, thrombotic complications of, 224 Atrial fibrillation (AF), 164, anticoagulation initiation for, following cardiac surgery, 184 inpatients requiring cardioversion, anticoagulation in, management, 186 nonvalvular, stroke prevention in, 77 valvular, Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE), 213 B Bioprosthetic heart valves, 188 Bivalirudin (Angiomax ), 234, 259, 262, 316, 344, 348 Bleeding Patient with HIT, Bleeding risk, intracranial hemorrhage (ICH), in warfarin therapy, Bridging therapy, optimal timing of, 169 C Cangrelor, 55 CAPRIE trial, 53 Cardiac surgery, atrial fibrillation following, 184 Cardioembolic stroke prevention, , See also Atrial fibrillation (AF) Cardiogenic embolism patients, Cardiopulmonary bypass (CPB), Catheter-directed thrombolysis, Chinese Acute Stroke Trial (CAST), 210 Chronic kidney disease (CKD), anticoagulation in, arterial thromboembolism treatment indications in, 244 clinical trial substudies in, Enoxaparin dosing strategies for, fondaparinux in, injectable DTIs in, low-molecular-weight heparins in, clinical trials and substudies, 252 dosing adjustments, 244 dosing recommendations in, , 255 pharmacokinetic evaluations, 248 unfractionated heparin in, 243 VTE treatment indications in, 244 Cilostazol, action mechanism, 61 adverse effects, 63 contraindications, 62 dosage, 62 drug interactions, 62 historical perspective, 61 indications, 62 monitoring of effect, 63 overdose, 63 pharmacodynamics, 61 pharmacokinetics, 61 pharmacology, 61 preparations, 62 Citrate infusion, 266 CLARITY trial, 53 Clopidogrel (Plavix ), 51 55, 216 action mechanism, 51 adverse effects, CAPRIE trial, 53 CLARITY trial, 53 COMMIT trial, 53

3 Index 417 contraindications, 54 CURE trial, 53 dosage, drug interactions, 54 historical perspective, indications, monitoring of effect, 53 overdose, 55 patients questions, 52 pharmacodynamics, 52 pharmacogenomics, 52 pharmacokinetics, 52 pharmacology, Clopidogrel and Aspirin Versus Aspirin Alone for the Prevention of Atherothrombotic Events (CHARISMA) trial, 217 Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE), 216 Cockcroft Gault (C-G) equation, 242 COMMIT trial, 53 Contact activation coagulation pathway, 29 Continuous external compression therapy (CECT), 114 Coumarin derivatives, 26 CURE trial, 53 Cyclooxygenase 1 (COX-1), 47, 115 Cyclooxygenase-2 (COX-2), 47 CYP2C9 inhibitors, 32, D Dabigatran etexilate, 69, 73 74, 76 77, 353 Re-COVER study, 76 RE-LY Trial, 78 Dalteparin (Fragmin ), 246, , 264, Danaparoid, 344, 349 Deep-vein thrombosis (DVT), 81 82, 87 88, 116, , See also Pulmonary embolism (PE); Venous thromboembolism (VTE) in absence of prophylaxis, 82 acute DVT, treatment, 142, 148 anticoagulation for VTE, duration, 154 Desirudin in preventing, 348 DVT prophylaxis in perioperative setting, with LDUH, extended DVT prophylaxis after total hip replacement, 129 fondaparinux in preventing, 118, in IPC group, 114 LMWH for, 139 lower-extremity DVT, thrombolysis in, in orthopedic patients, outpatient treatment of, candidate selection for, and PE, 123 postoperative DVT risk, screening method, in surgical patients, as VTE risk factor in hospitalized patients, 83 Delayed-onset HIT, 336 Desirudin (Iprivask ), 262, 344, 348 Desmopressin, 292 Dipyridamole, 59 61, 217 action mechanism, 59 adverse effects, 61 contraindications, 60 dosage, 60 drug interactions, 60 historical perspective, indications, monitoring of effect, 60 overdose, 61 pharmacodynamics, 59 pharmacokinetics, 59 pharmacology, 59 preparations, 60 Direct thrombin inhibitors (DTIs), 119, , argatroban, 316, bivalirudin, 316, 344, 348 bleeding rates associated with, 316 in CKD patients, ACUITY) trial, 261 Bivalirudin monotherapy, 259 clinical trials, 259 indications, 262 manufacturer dosing recommendations, 262

4 418 Index Direct thrombin inhibitors (DTIs) (Continued) pharmacokinetics, 259 REPLACE-2 trial, 259 dabigatran, 315, 353 danaparoid, , 349 desirudin, 344, 348 fondaparinux, 349 in hospitalized patients, lepirudin, 316, in obese patients, 283 reversal of, 315 rivaroxaban, 315, 353 in United States, 315 Ximelagatran, 353 Drug-eluting stents (DES), 173 Dual antiplatelets, E Early-stage NSTEACS, Ecarin clotting time (ECT), 69 Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q wave Coronary Events (ESSENCE), 252 Embolization, risk factors for, Endocarditis setting, anticoagulation in, Enoxaparin (Lovenox ), 8 12, 21 22, 87 91, 119, 170, , , , 265, , 408 in chronic kidney disease, 246, in DVT prevention, in joint replacement surgery, in obese patients, 20, 269, 282 in orthopedic surgery patients, 125, parenteral medications in ACS management, 228, , 234 pharmacodynamic properties, 245, protamine for LMWH reversal, 312 in renal failure, 19 SYNERGY trial, 310 thromboprophylaxis trials, 89 91, 94, in VTE prophylaxis, 244, , 309, 407 Enzyme immune assay (EIA), 337 Eptifibatide, 57 European/Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT), 217 European Cooperative Acute Stroke Study (ECASS), 208 European Stroke Prevention Study (ESPS-2), 217 Extended medical prophylaxis in acutely ill medical patients (EXCLAIM), 97 F Factor Xa inhibitors, 67 78, 349, See also Apixaban; Rivaroxaban future therapies, 237, 349, 353 in HIT, 344 indirect, in VTE prevention studies, 71 FASTER trial, 211 Fibrinogen uptake test (FUT), 91 Fondaparinux (Arixtra ), 10 13, 118, , 235, 247, 265, , 344, 349 in chronic kidney disease patients, dosing, 13 FDA-approved doses for, harmacokinetics, 12 in hospitalized patients, ACS, 313 VTE, 312 VTE treatment, monitoring, 13 in obese patients, 282 pharmacology, 12 reversal of, Fresh-frozen plasma (FFP), 236, G Gasping syndrome, 19 Genetics of warfarin, Glomerular filtration rate (GFR), 242 Glucose-6-phosphate dehydrogenase (G6PD), 49 Glycoprotein IIb/IIIa antagonists, 55 59, 233 action mechanism, 56 adverse effects, 58

5 Index 419 contraindications, 58 dosage, drug interactions, 58 historical perspective, indications, 57 monitoring of effect, 58 overdose, 59 pharmacodynamics, 56 pharmacokinetics, 56 pharmacology, preparations, 58 GRACE risk model, 227 Graduated compression stockings (GCS), 97, 114 H Hemodialysis, anticoagulants in, 69, , 334 Hemorrhage, 14 15, 58 HEMORR 2 HAGES index, Hemorrhagic complications in hospitalized patients, acute coronary syndrome, bleeding incidence, direct thrombin inhibitors (DTIs), fresh-frozen plasma (FFP), intracranial hemorrhage (ICH), low-molecular-weight heparin in, 309 major hemorrhage for LMWH, 311 management, 292 prothrombin complex concentrates (PCCs), 303 recombinant factor VIIa (rfviia), reversal of LMWH-associated bleeding, VTE prophylaxis, 309 warfarin, , See also individual entry warfarin-associated, estimating, Heparin-induced thrombocytopenia (HIT), 16 19, 140, antibody assays, antibody seroconversion, 334 bleeding patient with, clinical features of, diagnosis, 17, diagnostic challenges, inverted V platelet kinetics, 342 pseudo-hit disorders, 342 isolated HIT, 332, 346 new anticoagulants, pathophysiology, patterns of presentation, delayed-onset HIT, 336 rapid-onset HIT, 335 typical-onset HIT, 335 platelet count monitoring, posttest probability determinination, pretest probability determinination, 339 4Ts scoring system for, 340 prevalence, reexposure to heparin, 353 therapy choice, treatment of, vitamin K antagonists, Heparins, , 234, , See also Heparin-induced thrombocytopenia (HIT); Low-molecular-weight heparin (LMWH); Parenteral anticoagulants; Unfractionated heparin (UFH) administration, 117 intravenous unfractionated heparin, low-dose unfractionated heparin (LDUH), overdose, 117 in surgical patients, VTE prevention, Hirudin (lepirudin), 234 Hospitalized patients, acute VTE treatment in, additional measures, anticoagulation initiation, before initiating treatment, candidate selection for outpatient treatment, 142 goals, 137 IVC filter role, laboratory data, 151 medications, 151 postoperative VTE,

6 420 Index Hospitalized patients, acute VTE treatment in (Continued) precipitating events, 150 previous medical history, pulmonary embolism (PE), triaging the patient, Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA), 228 I Idraparinux, Immunity-mediated heparin-induced thrombocytopenia (HIT), 16 Indandiones, 26 Indirect factor Xa inhibitors, Inferior vena cava (IVC) filters, 114, efficacy of, 149 retrievable filters, 149 in VTE, 148 Intermittent pneumatic compression (IPC), 97, 114 International normalized ratio (INR), 29 and blood reserve, relationship, 31 International Stroke Trial (IST), 210 Intraarterial tpa, 209 Intracranial hemorrhage (ICH), , Intravenous antiplatelet therapy, , See also Antiplatelet therapies/medications; Non-ST-elevation ACS (NSTEACS): antiplatelet therapies Intravenous tpa, Intravenous unfractionated heparin, , See also Unfractionated heparin (UFH) Ischemic stroke, antithrombotics for, , See also Acute ischemic stroke management Isolated HIT, 332, 346 J Joint replacement surgery, venous thromboembolism (VTE), L Laboratory thrombophilia, testing for, acute setting, testing reliability in, underlying hypercoagulable states, 152 Left ventricular aneurysm postinfarction, Lepirudin (Refludan ), 262, 265, 316, Liver disease, Low-dose unfractionated heparin (LDUH), Low-molecular-weight heparin (LMWH), 1, 3, 8 12, , 139, , 234, 309, See also Enoxaparin (Lovenox ) in chronic kidney disease patients, dosing, 9 FDA-approved doses for, monitoring, 9 12 in obese patients, , See also under Obese patients, anticoagulation in pharmacokinetics, 9 pharmacology, 8 M Management of Atherothrombosis with Clopidogrel in High-Risk Patients with TIA or Stroke (MATCH) trial, 216 Measurevention, 406, 410 Medication administration record (MAR), Mitral stenosis with sinus rhythm, 185 Modification of diet in renal disease (MDRD), 242 Myocardial infarction (MI) left ventricular thrombus following, prevention and treatment, risk factors for stroke following, 194 N National Comprehensive Cancer Network (NCCN), 124 National Kidney Foundation (NKF), 242 National Patient Safety Goal (NPSG), 98, 291, 299, , , 393 Neurosurgery patients, VTE prophylaxis in,

7 Index 421 Newer oral anticoagulants, 67 78, See also Apixaban; Dabigatran; Rivaroxaban Non-immunity-mediated heparin-associated thrombocytopenia (HAT), 16 Nonischemic cardiomyopathy, anticoagulation strategies, risk factors, 196 Nonpharmacologic VTE prophylaxis, continuous external compression therapy (CECT), 114 graduated compression stockings (GCS), 114 intermittent pneumatic compression (IPC), 114 Non-ST-elevation ACS (NSTEACS), anticoagulation, antiplatelet therapies, aspirin, glycoprotein IIb/IIIa inhibitors, 233 initial conservative strategy, 230 initial invasive strategy, 230 thienopyridines, antithrombins, antithrombotic therapy for, direct thrombin inhibitors, discharge medications, early invasive approach, timing of, 235 early-stage NSTEACS, ACC/AHA guidelines, 227 early conservative management, 229 early invasive management, 229 early invasive strategy, 226 early management, early triage, parenteral medications, 228 risk stratification, heparins, 234 special circumstances, Non-ST-segment-elevation myocardial infarction (NSTEMI), 306 Nonsteroidal anti-inflammatory drugs (NSAIDs), 49, 236 Nonvalvular atrial fibrillation, Novel anticoagulants, , See also Dabigatran; Oral anticoagulants; Newer oral anticoagulants; Rivaroxaban O Obesity/Obese patients, anticoagulation in, 20, fondaparinux, 282 LMWH in, dosing strategies, 282 efficacy, 269 pharmacodynamic evaluation, 269 pharmacokinetic evaluation, 269 safety, 269 in thromboembolic disease patients, , in VTE prophylaxis, 272 pharmacokinetic considerations in, 267 alterations in obesity, 267 unfractionated heparin, dosing strategies in, 268 efficacy, 268 safety, 268 trials evaluating, Oral anticoagulants, , See also Newer oral anticoagulants clinical considerations, Oral anticoagulants, 67 78, clinical considerations, clinical trials, perioperative management of, bleeding risk, cost, 170 major surgery, 166 minor surgery, 166 optimal strategy, 168 strategy, thromboembolism risk stratification, VTE, 165 pharmacology, Oral direct factor Xa inhibitor (ODIXa), 71 Organization to Assess Strategies in Ischemic Syndromes (OASIS-5), 252 Orthopedic surgery patients, VTE in, ACCP recommendations for, elective spine surgery, 125 elective total hip replacement, 125

8 422 Index Orthopedic surgery patients, VTE in (Continued) elective total knee replacement, 125 hip fracture surgery, 125 spinal cord injuries, 125 Osteopenia, 22 Osteoporosis, 16 Outpatient bleeding risk index, 299 P P2Y12 receptor antagonists, 51 55, See also Clopidogrel (Plavix ) newer, 55 Parenteral anticoagulants, 1 23, , See also Chronic kidney disease (CKD); Enoxaparin (Lovenox ); Obese patients, anticoagulation in; Unfractionated heparin (UFH) adverse events, hemorrhage, heparin-induced thrombocytopenia, osteoporosis, 16 reversing anticoagulant effects, special populations, Parenteral medications in ACS management, 228 Parenteral nutrition, 36 Partial thromboplastin time (PTT), 182 Patent foramen ovale (PFO), 214 Patent Foramen Ovale in Cryptogenic Stroke Study (PICSS), 215 Patient education, 22 23, , See also Transitions in care Pediatrics, Pharmacologic VTE prophylaxis, 115 Plasmapheresis, 351 Platelet count monitoring, Platelet factor 4 (PF4), 17, Platelet-active drugs, Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, 211 Post myocardial infarction, myocardial infarction, risk factors for stroke following, 194 Postoperative VTE, Postthrombotic syndrome (PTS) prevention, Prasugrel, Prasugrel (Efient ), 55 Pregnancy, Present on admission (POA) qualifier, 406 Prevention Regimen for Effectively Avoiding Second Strokes (PRo-FESS) trial, 217 Prolyse in Acute Cerebral Thromboembolism (PROACT), 209 Prophylaxis, VTE, contraindications to, 130 duration of, initiation of, for neurosurgery patients, nonpharmacologic VTE prophylaxis, in obese patients, for orthopedic surgery patients, recommendations from professional societies for, ACCP guidelines, 120 in high-risk surgeries, in moderate surgeries, using combination modalities, Prosthetic valve patient, anticoagulation reversal in, Prosthetic valve thrombosis, 190 Protamine sulfate, 15 16, 117, , , 317, See also Hemorrhagic complications in hospitalized patients Prothrombin complex concentrates (PCCs), 303 Prothrombin time (INR), 69 Proton pump inhibitor (PPI), 236 Provoked thromboembolism, 150 Pulmonary embolism (PE), 81, acute PE, treatment algorithm for, 143 echocardiography, 144 Pulmonary Embolism Severity Index (PESI) score, 144 risk stratification in, 143 intermediate-risk, 144 specificity, 144 Purple toe syndrome, 28 PURSUIT risk model, 227

9 Index 423 Q Quality improvement strategies, best practices in anticoagulation, identifying, current environment and performance, assessing, 382 effect of interventions, monitoring, analyzing variation from protocol, tracking and trending data over time, 390 institutional support, obtaining, 379 measurement system, developing, outcome measures, 382 process measures, 385 structure measures, 385 using automation and sampling, 386 using balanced set of measures, 382 multidisciplinary team, forming, National Patient Safety Goal , 381 scope of patients improvement efforts, 378 specific strategies and tools for improving, implementation process, 388 opt out design, 389 ordersets, creating, triggered consultation, R Rapid-onset HIT, 335 Rebound anticoagulation, 303 Recombinant factor VIIa (rfviia), 303 Recombinant prourokinase (r-prouk), 209 RECORD 1 trial, 71 Reduced clinical events (REPLACE) 2 trial, 259 RE-MODEL trial, 73 Renal replacement therapy, anticoagulants in, direct thrombin inhibitors, 263 unfractionated heparin, 263 Reversal/Reversibility, 291 anticoagulant effects, of anticoagulation for life-threatening bleeding, of LMWH-associated bleeding, of warfarin, 301 Reye s syndrome, 50 Risk assessment models (RAMs), venous thromboembolism (VTE), Rivaroxaban, 68 69, 71 73, 75 76, 353 Einstein study, 76 S Safety and Efficacy of Enoxaparin in Percutaneous Coronary Intervention Patients (STEEPLE) trial, 252 Selective serotonin reuptake inhibitors (SSRIs), 50 Serotonin release assay (SRA), Smoking, 35 Specific, measurable, attainable, relevant, and time-bound (SMART), 378 ST (segment)-elevation myocardial infarction (STEMI), 22, 194, Stroke Prevention in Reversible Ischemia Trial (SPIRIT), 218 Studies of Left Ventricular Dysfunction (SOLVD), 214 Subcutaneous unfractionated heparin, 140, 308 Surgical patients, VTE prevention in, DVT prophylaxis in perioperative setting, emerging therapies in, 131 heparins, high risk level, 113 low risk level, 113 moderate risk level, 113 patient-specific risk factors, 110 pharmacologic VTE prophylaxis, 115 platelet-active drugs, risk factors, vitamin K antagonists, 116 VTE prophylaxis using combination modalities, , See also Prophylaxis, VTE Survival and Ventricular Enlargement (SAVE), 214

10 424 Index T 4Ts scoring system, 340 Thienopyridines, 174, 216, Thrombin clotting time (TCT), 69 Thromboembolism provoked, 150 risk factors for, 151 risk stratification, atrial fibrillation, 164 mechanical heart valves, treatment in obese patients, unprovoked, 150 Thromboembolism prophylaxis, 306 in obese patients, Thrombolysis candidates identification for, catheter-directed, in lower-extremity DVT, Thrombolysis in Myocardial Infarction (TIMI), 252 Thrombolytic therapy, Thromboprophylaxis, in hospitalized medical patients, optimal duration of, Thrombosis, 17 Thromboxane A2 (TXA2), 48 Ticagrelor (Brilinta ), 55, 233 Ticlopidine, 216 Ticlopidine Aspirin Stroke Study (TASS), 216 Tinzaparin (Innohep ), 19, 245, 247, , 265, Tirofiban, 56 Tissue factor coagulation pathway, 29 Total hip arthoplasty (THA), 72 74, See also Surgical patients, VTE prevention in Total knee arthoplasty (TKA), 70 72, 74, See also Surgical patients, VTE prevention in Transesophageal echocardiography (TEE), 180 Transient ischemic attack (TIA), 210 Transitions in care, discharge checklist, creating, follow-up after discharge, appointment scheduling, 367 patient education improving strategies, teachback method, 369 inpatient and outpatient medication lists, reconciling, 362 inpatient outpatient communication, facilitating, multidisciplinary team, using, 365 optimization of health systems, patients after discharge, caring, follow-up phone calls, 365 Transthoracic echocardiogram (TTE), 190, deep-vein thrombosis (DVT), Typical-onset HIT, 335 U Underlying hypercoagulable states, 152 Unfractionated heparin (UFH), 1 8, 96 97, , 234, 305, 307 action mechanisms, 3 bleeding management, 307 bleeding risk, 307 in chronic kidney disease patients, 243 continuous intravenous infusion, 3 dosing, 4 5 administration route, 5 intravenous (IV) administration route, 5 subcutaneous (SC) administration route, 5 IV unfractionated heparin, 308 monitoring, 4 8 in obese patients, pediatrics, pharmacokinetics, 2 4 pharmacology, 2 subcutaneous unfractionated heparin, 308 Unprovoked thromboembolism, 150 V Valve thrombosis, management, Valvular atrial fibrillation, Valvular heart disease, anticoagulation in endocarditis setting, bioprosthetic heart valves, 188

11 Index 425 mechanical heart valves, mitral stenosis with sinus rhythm, 185 in patients with prosthetic valves, bridging therapy for, reversal of anticoagulation, Vena cava filters (VCFs), 351 Venous thromboembolism (VTE), 1, 74 77, , 165, See also Deep-vein thrombosis (DVT); Pulmonary embolism (PE) anticoagulation duration for, Apixaban, clinical data in prevention, in hospitalized acutely ill medical patients, 86 in hospitalized patients, 86 primary studies, current controversies, future directions, in hospitalized patients, thromboprophylaxis underutilization in, for joint replacement surgery, total knee arthoplasty (TKA) study designs, 70 management, best practices, identifying, building an institutional protocol, implementation method, metrics for, meta-analyses, National quality measures, optimal frequency of UFH in, pathophysiology, prevalence of, prevention, alerts, 410 assessing current practices, 405 hospital-acquired VTE, identifying local best practices, implementation and reinforcement of protocol, three-bucket VTE prevention orderset, 408 using checklists and prompts, 409 prevention in surgical patients, , See also under Surgical patients prevention of, in hospitalized acutely ill medical patients, prophylaxis, 309 recommendations in hospitalized acutely ill medical patients, 93 risk assessment models (RAMs), risk factors for, systematic reviews, thromboprophylaxis, treatment, 306, 310 VTE prophylactic therapies, See Prophylaxis, VTE Virchow s triad, 266 Vitamin K antagonists (VKAs), 25 42, 116, , , adverse reactions, anticoagulation proteins, 28 coagulation cascade, 29 contact activation pathway, 29 tissue factor pathway, 29 coagulation factors, 28 coumarin derivatives, 26 disease state, dosing, duration, 352 in hospitalized patients, indandiones, 26 pharmacodynamics, pharmacokinetics, risk factors for, 352 Vitamin K intake, 33 foods containing, 34 W Warfarin, 18, 26 27, 29, 141 algorithms for dosing, aspirin versus, 181 dosage adjustments during maintenance phase, 42 dose variability, factors influencing, age, 31 alcohol, body size, 31

12 426 Index Warfarin (Continued) drugs, 32 enteral feeding, 36 gender, 31 genetics, heart failure, 35 initial dosing, liver disease, parenteral nutrition, 36 race, 32 smoking, 35 thyroid disease, 34 dosing strategies, for hemorrhagic complications in hospitalized patients, initiation and maintenance, addressing transitions in protocol, 394 care transitions ownership, 397 identifying best practices and regulatory standards, 393 institutional warfarin protocol, designing, key frontline providers in selection, 394 nomogram, using, 395 prepackaged educational materials, reviewing existing tools for, 394 nomograms for dosing, pharmacogenetic tests, 41 reversal of, 301 time to reach steady state, factors influencing, 41 warfarin protocol, monitoring adherence and impact of, warfarin therapy, monitoring, Warfarin and Aspirin in Recurrent Stroke Study (WARSS), 215, 218 Warfarin Aspirin in Symptomatic Intracranial Disease (WASID) trial, 218 Warfarin versus Aspirin for Reduced Cardiac Ejection Fraction (WARCEF), 214 X Ximelagatran, 353