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Resource Center

Drug Therapy Management

Anticoagulation Discontinuation/Reversal

 Antithrombotic Reversal Guideline
 Management of Anticoagulation Therapy - Presentation from Chest Guidelines
 Patient Compliance - ranking smart phone apps for compliance, JAPhA, March 2013
160 adherence apps identified and ranked and most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of basic medication reminder features & enhanced levels of functionality.
 Reversal of TSOACs
2012 chart with reversal of Apixaban, Dabigatran and Rivaroxaban
 TSOAC Reversal, 2012
European Heart Journal; Crowther & Siegal,12/2012 reviews NOACs & summarizes published rates of major bleeding, use & limitations of coagulation testing,potential reversal agents,management of acute bleeding associated with use of NOACs

Anticoagulation Initiation

 Ambulatory Warfarin Protocol
guideline outlines the evidence for managing anticoagulation therapy with oral vitamin K antagonist (warfarin). Evidence is based on recommendations from the Antithrombotic Therapy nd Prevention of Thrombosis, 9th edition: American College of Chest Physicians Clinical Practice Guidelines
 Guide to Managing Warfarin Theapy for Hospitalized Patients
UNM Warfarin Dosing guideline for inpatient care, includes drug & food interaction and inpatient warfarin dosing adjustment nomogram (for target INR 2-3)
 Guideline for Anticoagulation Initiation (Kaiser Permanente)
Independent institutional example for basic drug initiation,therapeutic range
 ISTH Recommendations for TSOAC Patient Selection
 Management of Anticoagulation Therapy - Presentation from Chest Guidelines
 Oral Agents for Stroke Prevention in Nonvalvular AF (LINK)
 Oral Agents for Stroke Prevention in Nonvalvular AF (PDF)
 Pediatric Anticoag Guidelines from The Children's Hospital of Philadelphia, 2014
multiple guidelines including anticoagulation medication guidelines for management of pediatric blood clots/thromboembolic disorders created by The Children's Hospital of Philadelphia & Dr. Dr. Leslie Raffini, 2014; Heparin, Enoxaparin & Coumadin included
 Sample Warfarin Ambulatory Protocol
 TSOAC Comparison Chart for Dabigatran, Rivaroxaban & Apixaban
Comprehensive chart, May 2013 including Dabigatran, Rivaroxaban, Apixaban, outlining uses, dosing, drug interactions, monitoring, special considerations, transitions of care & relevant studies; from the San Francisco VA
 TSOAC Guideline for Hospitalized Patients, 2013
 VTE Initial Management Algorithm
 Warfarin 10 mg Dose Initiation Nomogram
 Warfarin 5 mg Initiation Nomogram

Anticoagulation Maintenance

 Ambulatory Warfarin Protocol
 Can we increase interval of INR Testing?
 Coumadin Work Flow
An alert system developed by Dean Health for drug interactions with warfarin. Electronically alerts the prescriber when the medication is added to the med list of a patient taking warfarin with integration into the EMR
 Guideline for Anticoagulation Maintenance
 Management of Anticoagulation Therapy - Presentation from Chest Guidelines
 Sample Warfarin Ambulatory Protocol
 TSOAC Drug & Food Interactions
PowerPoint presentation outlining Drug/Drug and Drug/Food Interactions with Target-Specific Oral Anticoagulants; Sara R. Vazquez, PharmD, BCPS, CACP University of Utah Health Care Thrombosis Center

Complications During Therapy

 Antithrombotic Therapy and Prevention of Thrombosis
 Coumadin Work Flow
An alert system developed by Dean Health for drug interactions with warfarin. Electronically alerts the prescriber when the medication is added to the med list of a patient taking warfarin with integration into the EMR
 Guideline for Managing and Triage of Anticoagulation Therapy Problems
 HEMORR2HAGES Risk Assessment Tool
 Management of Extended Travel
 Monitoring LMWH During Pregnancy
2013 Chart from UW Medicine offering guidance for monitoring of LMWHs during 3rd trimester of pregnancy
 Recommendations for Air Travel
Overview of how to prevent VTE during travel, and how to diagnose and treat VTE from Cleveland Clinic, Feb, 2011
 Reversal of TSOACs
2012 chart with reversal of Apixaban, Dabigatran and Rivaroxaban
 TSOAC Reversal, 2012
European Heart Journal; Crowther & Siegal,12/2012 reviews NOACs & summarizes published rates of major bleeding, use & limitations of coagulation testing,potential reversal agents,management of acute bleeding associated with use of NOACs

Comprehensive Management of TSOACs

 Clinical Practice Guideline on Use of Antithrombotics in NVAF July 2014    NEW
17 page guide outlining considerations in deciding between ASA, warfarin and various TSOAC agents from UW Health, July 2014. Includes flow diagram that points providers in the direction of appropriate agents based on patient-specific information.
 European Heart Rhythm Society Practical Guide on use of TSOACs in Non-Valvular AFIB
 Reversal of NOACs
2012 chart with reversal of Apixaban, Dabigatran and Rivaroxaban
 Reversal of target-specific oral anticoagulants Deborah M. Siegal, Adam Cuker, May 2014    NEW
6-page article from Drug Discovery Today, May 2014; Summarizes the available evidence for TSOAC reversal using nonspecific and specific reversal agents
 Reversal Strategies for Newer Anticoagulants, May 2013 Today's Hospitalist
Comprehensive article outlining reversal for new oral anticoagulants with links to useful protocols
 Target Specific Anticoagulants Patient Selection ASH 2012
 Transitioning to and from the novel oral anticoagulants: a management strategy for clinicians    NEW
J Thromb Thrombolysis Feb 2014, Elsayed Abo-Salem,Richard Becker 8-page article focuses on transitioning to and from TSOACs employing a practical pharmacokinetic- and pharmacodynamic-based approach.
 TSOAC Comparison Chart for Dabigatran, Rivaroxaban & Apixaban
Comprehensive chart, May 2013 including Dabigatran, Rivaroxaban, Apixaban, outlining uses, dosing, drug interactions, monitoring, special considerations, transitions of care & relevant studies; from the San Francisco VA
 TSOAC Drug & Food Interactions
PowerPoint presentation outlining Drug/Drug and Drug/Food Interactions with Target-Specific Oral Anticoagulants; Sara R. Vazquez, PharmD, BCPS, CACP University of Utah Health Care Thrombosis Center
 TSOAC Drug Interaction Summary Page
Comprehensive summary including USA FDA, Canada and EMA guidelines for Dabigatran, Rivaroxaban and Apixaban, as of 7/2013,Sara R. Vazquez, PharmD, BCPS, CACP University of Utah Health Care Thrombosis Center
 TSOAC Reversal, 2012
European Heart Journal; Crowther & Siegal,12/2012 reviews NOACs & summarizes published rates of major bleeding, use & limitations of coagulation testing,potential reversal agents,management of acute bleeding associated with use of NOACs

VTE Prevention and Treatment

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