CPE04 Dabigatran

Medication of the week is Dabigatran.

Good day everyone medication of the day is baby electron navigation it takes sleep with eyelids as well as its active metabolites assiduonites are competitive dark throughout the hammer which prevent travis development by inhibiting both free as well as clock bound thrombin as well as thrombin induced plated aggregation diabetes is used therapeutically the treatment

Of venous thromboembolism and is also indicated prophylactically in prevention of systemic embolism in non-valuable atrial fibrillation and also used in prevention of post-operative complications such as deep intraverses and binary embolism in patients undergoing total hip replacement as the second it’s used in the secondary prevention following an episode of

Famous thromboembolism dosing is indication and weight specific with some dosing adjustments and renal dysfunction as well it is available in two dosage forms that vary in approved indications as well as age groups these dosage forms can’t be used interchangeably and never attempt a milligram to milligram substitution or combine different dosage forms to achieve

A dope dose conversion between different anticoagulants and different administration with the signs by itself and will not be discussed here do not attempt without obtaining clarity precautions contraindications and interactions are plentiful so be there during the prescription knowledge or screening today we shall be looking at um the most important counseling

Points along with boxed warnings in stocks motivation when you encounter them the new organizational prescription for dabigatran so moving ahead uh do not discontinue unless directed by a physician this is a very important instruction to any patient who is receiving david trent upon premature discontinuation the risk of thrombotic evidence is increased if the

Damage attract must be discontinued for a reason other than the technological bleeding or completion of a cause of therapy consider the use of another anticoagulant during the time of interruption next up report symptoms uh of spinal or epidural hematoma this is absolutely important and we need to consider the risks and benefits before any new axial intervention

In patients who are anticoagulating up or are going to be anticoagulated because of the possibility of developing spinal or epidural hematoma in patients on daily veteran and are receiving the neuraxial anesthesia or undergoing spinal function this is very important and there are certain factors that will put patients at risk and this includes invalid uh epidural

Cancer condoms of medications affecting the hemostasis such as enzymes plated inhibitors other anti-coagulants and for patients with a history of dramatic or repeated epidural spinal punctures as well as those with the history of spinal deformity of spine century so patients have to be informed that they will have to notify their physician prior to any procedure

And they will have to disclose the use of david veteran just like any regular medication but because of this black box warning it becomes super super important going ahead to immediately report symptoms of bleeding just as in any um anticoagulant use this is important the most common complete complication of any antibodies is bleeding including those that could

Be severe and potentially fatal risk factors from leading money to the concurrent use of drugs that increase the risk of bleeding such as anxieties caffeine as with patients with renal impairment and in elderly patients especially if they’ve got low body weight and we have to this continuing patient with active pathological moving so in this case the patient

Should be instructed to immediately report for symptoms of leading to their treating physician that becomes important although we also mentioned that we should not be abruptly discontinuing therapy without discussing with the physician the only exemption is certainly bleeding but this has to be this has to go through the treatment physician patients should

Not be advised to discontinue on their own they have to go back to the action position that becomes an important point to be concerted next ahead it should be advised to report for any of these important reading problems that we have discussed just a couple of minutes ago and also about any allergy through this medicine or any part of it and that they have to

Elaborate their allergy with signs and symptoms and if at all they are undergoing any heart bad replacement difficult they have been diagnosed with any kidney problems if it’s all have received a diagnosis of antiphospholipid syndrome and if at all they are on treatment would draw near their own or ketoconazole or reframing and if the patient is breastfeeding

Or they are learning to when uh on navigation that’s also another point to consider patient is on variation and they are being recommended from your neurology technology sampling as well as if they are being um initiated on any of these medicines while on that rejection both ways it’s equally important next ahead regarding over-the-counter medicines uh always

Advise patients to report the use of dedication to any physician prior prescribing any nervous prior administration of any medicines and pharmacists prior dispensing any medicines all three healthcare workers are equally important moving ahead to side effects side effects to really watch out for who include these points gastrointestinal symptoms of dyspepsia or

Gastritis or any adverse reactions such as abdominal discomfort or pain abdomen hemorrhage whatsoever it would be gastrointestinal inflammatory urinary and any uh allergic engineering or electrolytic reactions are also important to look after for going ahead to start advice patients to use only one bottle of mr pack at a time and it make advice against the use

Of film box or any medicine organizer we might recommend this to people on multiple medications to help the remember take the right medicine at the right time however when it comes to dabbing actually we are going to advise against the use of build walks or medicine organization as an entrepreneur as you notice these trips are printed with these of the week already

So it is it comes this way so that becomes totally unnecessary to remove and put it on medicine organizes and if at all they’ve got an open bottle they are not going to use it anytime beyond four months and we also advise to advise the patient to remove only one capsule at a time of use and to immediately close the bottle tightly after use and after this comes

Administration in adults uh will be asking patients to swallow as a whole with a full glass of water do not chew break or open capsules and twice daily doses should be as close as possible to 12 hours and if your toilet repeat lipoprotein inhibitors are co-prescribed we are going to advise separating the timing by several hours at least and uh emptying contents of

A capsule we’ve already talked about it it should be avoided because it might result in increased drug exposure and with regards to big lipoprotein inhibitors we have already discussed uh relatively any systemic ketones all are important to be considered and moving ahead for administration pediatric population we would advise that this prank the caregiver sprinkles

Pellets on a teaspoon or mixes it with in the two teaspoons of room temperature soft food or it could even be mixed in one to two ounces of apple juice before for drinking before a meal the pellets should not be mixed with milk or with foods that contain milk do not chew advise the caregiver to make sure the child swallows the mixture as a whole immediately or with

A maximum time frame of 30 minutes from venetian preparation you know to use a syringe and not to administer by our feeding tube and to advise again storing this mixture for future use so immediately after preparation can do whatever is required if it is not consumed within the next 30 minutes discard and re-prepare when the baby is going to be and you must be a

Child and in case of uh mixing with uh i think i spoke about soft foods it could be any baby by cereal prepared with water it could be mashed carrots or applesauce mashed bananas or any of these kind of foods moving ahead to mixed doses to administer as soon as possible but to skip the dose if the next dose is less than six hours away and they advise against uh

Taking two doses at the time never developed justice and take it as soon as possible and the only exception is if the next duel dose is within six hours and in case of fashion consumption a second dance is generally recommended and it is advised to show you the next dose 12 hours later that concludes today’s video happy learning see you next saturday take care and stay safe

Transcribed from video
CPE04 Dabigatran By The Ultimate Learning for Pharmacists