DrPak

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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?
 
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CaptainZero

DrPak said:
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

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DrPak said:
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.
 
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DrPak

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smgilles said:
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

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DrPak said:
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).
 
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