Hellooo Friend!
Hema Here!
How to Deal the Need for the Novel Oral Anticoagulants in CSA?
When we clinically see a patient to assess the need for the Novel oral Anticoagulants, it is very important to blend our questions with the following points in mind.
1. Appropriate History and Examination.
2. Risk factors for Thromboembolism
3. Well’s score questions/ HAS BLED Scoring
4. Contraindications for anticoagulation
5. Local referral pathway
6. Support network
FIVE POINTS TO REMEMBER IN CSA ABOUT NOAC.
1. What are they?
They inhibit the Factor Xa and IIa Thrombin.
2. Examples?
Rivaroxaban, Apixaban and Dabigatran.
3. Indications?
For Rivaroxaban 15 mg and 20 mg.
a. Prevention of stroke and systemic embolism in adult patients with non valvular AF and >1 risk factor (Congestive Heart Failure, Hypertension, Age >75 yrs, DM, Prior Stroke or TIA).
b. Treatment of PE, DVT and prevention of recurrent DVT and PE in adults.
For Rivaroxaban 1o mg
Prevention of VTE in adult patients undergoing elective hip or knee replacement surgery.
4. Contraindications?
Bad Liver/ Kidney ( CrCl<15), Pregnant, Breastfeeding, on liver enzyme inducers like Ketoconazole, St John’s wort etc.
5. Complications?
Though it is non inferior to warfarin and have less risk for major bleeding like intra cranial bleeding, it carries slightly higher risk 3.1 % for GI bleeding than warfarin 2.1%..
Now, Practice it with lots of different scenarios and get ready for your CSA.
Thats it!
Enjoy!
To Your Success,
Hema xoxo.
General Practitioner.
Creator of Royal Amore & CSA SmartGroup & Ready to Shine
Author of CSA Success Grenade – Fundays.
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