Step I A. fib

[DrPak]

Patient with chronic A. fib needs to be given medication to prevent a systemic clot from forming and screwing him up.

What do we give him... warfarin, aspirin, unfractionated heparin, or streptokinase?

 

[CaptainZero]

Patient with chronic A. fib needs to be given medication to prevent a systemic clot from forming and screwing him up.

What do we give him... warfarin, aspirin, unfractionated heparin, or streptokinase?

Aspirin...warfarin & heparin are usually used for preventing venous clots, and streptokinase is usually only used in acute settings, if at all.

 

[smgilles]

Patient with chronic A. fib needs to be given medication to prevent a systemic clot from forming and screwing him up.

What do we give him... warfarin, aspirin, unfractionated heparin, or streptokinase?

You give coumadin unless there is a contraindication (i.e. recent bleed, head trauma, risk of falls, etc). If that is the case give aspirin.

 

[DrPak]

You give coumadin unless there is a contraindication (i.e. recent bleed, head trauma, risk of falls, etc). If that is the case give aspirin.

Why choose warfarin over aspirin? What's the reasoning?

 

[PuGanDoo]

Why choose warfarin over aspirin? What's the reasoning?

Aspirin is only an antiplatelet med. Warfarin/coumadin targets the vit K dependent clotting factors synthesized by the liver (II, VII, IX, X) it also affects the anti-clotting factors prot c and prot s. The anti-clotting factors are affected first and thus heparin overlap is often used initially until factor II is decreased. Other benefits of warfarin are oral admin, longer half-life, and it does not cause HIT (heparin induced thrombocytopenia).

 

[trudub]

Yep, the drug of choice in this situation is warfarin.