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Overview


Anticoagulants can be dangerous drugs. Developed to save lives by preventing and treating thrombosis, these widely used medications are linked to unacceptable levels of morbidity and mortality. According to a study by the Institute for Safe Medication Practices, 8.2% of hospitalized patients on warfarin and 13.6% exposed to heparin experience an adverse drug event. To prevent these events from occurring, clinicians monitor anticoagulation therapy closely. But there are still questions. What is the risk of stroke...

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Anticoagulation Therapy: A Point-of-Care Guide

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Overview


Anticoagulants can be dangerous drugs. Developed to save lives by preventing and treating thrombosis, these widely used medications are linked to unacceptable levels of morbidity and mortality. According to a study by the Institute for Safe Medication Practices, 8.2% of hospitalized patients on warfarin and 13.6% exposed to heparin experience an adverse drug event. To prevent these events from occurring, clinicians monitor anticoagulation therapy closely. But there are still questions. What is the risk of stroke in a patient who has specified CHADS2 risk factors? What is the recommended perioperative treatment? Find life-saving solutions quickly to these challenges and more with Anticoagulation Therapy: A Point-of-Care Guide, edited by William Dager, Michael Gulseth, and Edith Nutescu.

This concise reference is designed with the busy clinician and resident in mind. It provides a quick way to access necessary clinical and therapeutic information that has the potential to improve the lives when many risk factors are at play and time is of the essence.

Inside you’ll find:

  • Quick reference elements such as tables figures to easily access key information
  • Clinical pearls and bullets to highlight real life application
  • Selected guideline statements from leading organizations
  • 19 chapters covering a broad range of topics

The second book in the Point-of-Care series, Anticoagulation Therapy is led by a team of editors with more than 77 combined years of clinical experience, including insight from 19 contributors. The book is divided into three sections, including: Anticoagulation Medication Management, Conditions Requiring Anticoagulation Therapy, and Practical Monitoring and Coagulation Laboratory Insights.

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Editorial Reviews

MedInfoNow

**Description**
This comprehensive guide to anticoagulants describes how they work, how they are used, clinical issues, and monitoring parameters and reversal guidelines.

**Purpose**
The purpose is to create a pocket guide that gives practitioners quick access to evidence-based and expert information on the use of anticoagulants in various types of patients.

**Audience**
The audience of clinical practitioners would include physicians in various specialties, including orthopedists, cardiologists, internists, general practitioners, residents, and medical students, as well as nurse practitioners,
physician assistants, and pharmacists.

**Features**
The book discusses different anticoagulants, their mechanisms of action, dosing guidelines, monitoring parameters, and reversal guidelines. The clinical pearls are really helpful in addressing various situations such as dosing a morbidly obese patient. Many tables help make dosing comparisons, patient group comparisons, risk assessments, etc. Unfortunately, the font on some of the flow charts, diagrams, index, and back cover is very small and difficult to read.

**Assessment**
This is a wonderful little pocket guide to anticoagulation therapy. It is comprehensive, yet simplified. Updates will be needed as newer drug therapies come to market.

-----------------------------------------------------------

Weighted Numerical Score: 84 - 3 Stars

Judith Klevan, BA biology, BS Phamacy(Jeanes Hospital)

 

— Judith Klevan, BA biology, BS Phamacy(Jeanes Hospital)

The Annals of Pharmacotherapy
Both practitioners who are focused in the area of anticoagulation and those who provide general pharmacotherapy services will find this to be a useful reference text. The specific focus of the text and the purchase price likely will limit its feasibility for students. While there is variation in how chapter authors have applied structure concepts, each has provided succinct and comprehensive information. The strength of the book is that it achieves the goal of being a good point-of-care resource for day-to-day patient care.
— Michael P Rivey MS BCPS FASHP
The Pharmaceutical Journal
This excellent book has been written by authors who are experts in their fields of practice. It has met its objective in producing a useful guide for clinicians in any discipline caring for patients on anticoagulation therapy.
— Laurence Goldberg
MedInfoNow - Judith Klevan

**Description**
This comprehensive guide to anticoagulants describes how they work, how they are used, clinical issues, and monitoring parameters and reversal guidelines.

**Purpose**
The purpose is to create a pocket guide that gives practitioners quick access to evidence-based and expert information on the use of anticoagulants in various types of patients.

**Audience**
The audience of clinical practitioners would include physicians in various specialties, including orthopedists, cardiologists, internists, general practitioners, residents, and medical students, as well as nurse practitioners,
physician assistants, and pharmacists.

**Features**
The book discusses different anticoagulants, their mechanisms of action, dosing guidelines, monitoring parameters, and reversal guidelines. The clinical pearls are really helpful in addressing various situations such as dosing a morbidly obese patient. Many tables help make dosing comparisons, patient group comparisons, risk assessments, etc. Unfortunately, the font on some of the flow charts, diagrams, index, and back cover is very small and difficult to read.

**Assessment**
This is a wonderful little pocket guide to anticoagulation therapy. It is comprehensive, yet simplified. Updates will be needed as newer drug therapies come to market.

-----------------------------------------------------------

Weighted Numerical Score: 84 - 3 Stars

Judith Klevan, BA biology, BS Phamacy(Jeanes Hospital)

 

The Annals of Pharmacotherapy - Michael P Rivey MS BCPS FASHP

Anticoagulation Therapy: A Point-of-Care Guide
 
By William E Dager PharmD BCPS (AQ Cardiology) FCSHP FCCP FCCM FASHP, Michael P Gulseth PharmD BCPS, and Edith A Nutescu PharmD FCCP.
 
The Annals of Pharmacotherapy: July/August 2011 vol. 45 no. 7-8 page 1034-1035
Therapeutic Area: The book has a focus to describe aspects of the use and monitoring of anticoagulation therapy, including specific issues for patients in the areas of adult internal medicine, cardiology, pediatrics, and obstetrics.
Format: Soft-cover book that is handbook size, thus, small enough for easy portability and for possible use as a laboratory coat pocket reference.
Audience: The intended audience primarily is practitioners in all disciplines who are involved in the provision of anticoagulation therapy. The general nature of the handbook would make it a useful resource for students in pharmacy, medicine, nurse practitioner, and physician assistance programs. The extensive coverage of the field of anticoagulation also makes the handbook a good general reference for hospital and clinic pharmacies.
Purpose: This is the second point-of-care book by the American Society of Health-System Pharmacists. The book presents information in a succinct fashion and is designed to provide rapid retrieval of information regarding issues surrounding anticoagulation therapy.
Content: The book is divided into 3 major sections, including 1 focused on drug therapies in anticoagulation, 1 on diseases and conditions requiring anticoagulation, and 1 focused on coagulation laboratory testing. Nineteen chapters covering virtually all topics surrounding anticoagulation in an evidence-based approach compose the book. Extensive use of tables, figures of good quality, and bulleted listing of information enhances the usability as a reference. Clinical pearls are used to emphasize points, and a current reference list is provided at the end of each chapter, with key references typically highlighted. Current treatment guidelines and helpful algorithms are included when appropriate. Appendices include additional information on issues common in anticoagulation patients, although it is unclear why certain topics were not presented within chapters on the given topics.
Usability: The editors have achieved the goal of creating an easy-to-use reference. Topics in chapters are comprehensively addressed and information is current according to guidelines. The tables are well constructed, although some contain overly extensive wording and odd spacing that makes them difficult to read. Figures greatly enhance the understanding of presented concepts. Clinical pearls emphasize topic issues, but there is variation in what constitutes a clinical pearl. For example, Chapter 8 on bridging anticoagulation contains no highlighted pearls, while Chapter 10, on venous thromboembolism prevention, has virtually all text labeled as pearls. The same is true regarding the references, with some variation in how and whether key articles are identified.
Highlights: The primary feature of this book is the comprehensive inclusion of all medication management aspects related to anticoagulation therapy. Content is presented in an outline format that provides quick and easy access. Effort is clearly made to provide the reader with practical information through the use of tables and algorithms to manage common patient situations. The information is evidence-based and current, including available data on new anticoagulants. The authors are experienced clinicians regarded as anticoagulation pharmacy experts. Overall, the book is an excellent resource for anticoagulation therapy.
Limitations: The primary limitation of this book is the variability in which the authors use the intended structural approaches to presenting information. Clinical pearls cease to be pearls if they include rare occurrences or all aspects of a given topic. Some tables contain excessive text which lessens their usability. In addition, some algorithms are so extensive that they are presented in very small print size that is difficult to read.
Comparison with Other Related Books: A comparative anticoagulation therapy resource, Antithrombotic Therapy, by Becker, Fintel, and Green, is a handbook that was recently released in its 5th edition. That book, which is less than half the cost of the book reviewed here, also contains many useful tables and figures and current guidelines, but provides most chapter content in a formal text format. As such, the concise approach of this book makes it unique and easier to use as a true point-of-care resource. There are several textbooks on the topic of anticoagulation therapy, some focused in specific areas like cardiology, but few are current in the past 3 years since the comprehensive antithrombotic practice guidelines were released.
Reviewer's Summary: Both practitioners who are focused in the area of anticoagulation and those who provide general pharmacotherapy services will find this to be a useful reference text. The specific focus of the text and the purchase price likely will limit its feasibility for students. While there is variation in how chapter authors have applied structure concepts, each has provided succinct and comprehensive information. The strength of the book is that it achieves the goal of being a good point-of-care resource for day-to-day patient care.
Reviewer: Michael P Rivey MS BCPS FASHP, Professor and Chair of Pharmacy Practice, Skaggs School of Pharmacy, The University of Montana, Missoula, MT
 
The Pharmaceutical Journal - Laurence Goldberg

Anticoagulation Therapy: A Point-of-Care Guide
by William E. Dager, Michael P. Gulseth, Edith A. Nutescu.
 
The Pharmaceutical Journal 17th September 2011 Vol 287/7671 page 325

The editors of this book have set out to create a unique, pocket-sized point-of-care practice guide that would give clinicians quick access to evidence-based information or expert opinion for challenging clinical situations. The book is designed to be light on text, heavy on tables and figures, easy to digest, comprehensive, expertly written, applicable to patients across the continuum of care and useful to all healthcare workers involved with these medicines. This is quite a challenge.
The focus of the book is on the clinical use of anticoagulants. The information is organised according to the way that clinicians think through clinical problems.
The book is divided into three parts: anticoagulant medicines management, conditions requiring anticoagulant therapy and practical monitoring, and coagulation laboratory insights.
In the first part, several chapters are devoted to specific drug groups, including warfarin, unfractionated heparin, low molecular weight heparin, parenteral direct thrombin inhibitors and the newer oral anticoagulants. Although the chapter on the newer oral anticoagulants describes these agents as still being in development, the three drugs dabigatran, rivaroxaban and apixaban are compared and contrasted in great detail, with tables showing the results from the main published phase III clinical trials.
In the second part, chapters deal with conditions requiring anticoagulant therapy, including atrial fibrillation, acute coronary syndromes and prosthetic heart valves. Other chapters cover pregnancy and paediatrics.
A number of short miscellaneous appendices in diagrammatic or tabular format make up the final pages. Diverse subjects such as the coagulation cascade, cancer-related thromboembolism, drug related thrombocytopaenia and disseminated intravascular coagulation are covered.
This excellent book has been written by authors who are experts in their fields of practice. It has met its objective in producing a useful guide for clinicians in any discipline caring for patients on anticoagulation therapy.
Reviewer: Laurence A. Goldberg
Laurence A. Goldberg is a pharmaceutical consultant in Bury, Lancashire
 
 

Doody's Review Service
Reviewer: Judith Klevan, BSPharm (Jeanes Hospital)
Description: This comprehensive guide to anticoagulants describes how they work, how they are used, clinical issues, and monitoring parameters and reversal guidelines.
Purpose: The purpose is to create a pocket guide that gives practitioners quick access to evidence-based and expert information on the use of anticoagulants in various types of patients.
Audience: The audience of clinical practitioners would include physicians in various specialties, including orthopedists, cardiologists, internists, general practitioners, residents, and medical students, as well as nurse practitioners, physician assistants, and pharmacists.
Features: The book discusses different anticoagulants, their mechanisms of action, dosing guidelines, monitoring parameters, and reversal guidelines. The clinical pearls are really helpful in addressing various situations such as dosing a morbidly obese patient. Many tables help make dosing comparisons, patient group comparisons, risk assessments, etc. Unfortunately, the font on some of the flow charts, diagrams, index, and back cover is very small and difficult to read.
Assessment: This is a wonderful little pocket guide to anticoagulation therapy. It is comprehensive, yet simplified. Updates will be needed as newer drug therapies come to market.
Read More Show Less

Product Details

  • ISBN-13: 9781585282883
  • Publisher: ASHP
  • Publication date: 3/28/2011
  • Sold by: Barnes & Noble
  • Format: eBook
  • Pages: 504
  • Sales rank: 1,258,545
  • File size: 4 MB

Meet the Author


 
William E. Dager, Pharm.D., FCSHP, FCCP
Pharmacist Specialist, UC Davis Medical Center
Clinical Professor of Pharmacy
University of California, San Francisco
Clinical Professor of Medicine
University of California, Davis

William E. Dager, Pharm.D., FCSHP, FCCP, is Clinical Professor of Pharmacy at the University of California, San Francisco (UCSF) School of Pharmacy and Clinical Professor of Medicine at University of California, Davis School of Medicine. Dr. Dager received his doctor of pharmacy degree from UCSF and served a residency at the University of California, Davis Medical Center (UCDMC) in Sacramento. He also completed a preceptorship in nephrology/pharmaceutical care at the University of Pittsburgh School of Pharmacy.
In his role as a clinical specialist at UCDMC, Dr. Dager is responsible for managing difficult cases in anticoagulation, pharmacokinetics, and critical care.
Dr. Dager is a fellow of the California Society of Health-System Pharmacists (CSHP) and was recently recognized as a fellow of the American College of Clinical Pharmacy (ACCP).  In October 2008, Dr. Dager was honored with the ACCP Clinical Practice Award in recognition of his outstanding contributions in the area of clinical pharmacy practice.
Dr. Dager is a member of numerous professional organizations, including the Sacramento Valley Society of Heath-System Pharmacists, the Anticoagulation Forum, the International Society of Thrombosis and Haemostasis, the American Society of Health-System Pharmacists (ASHP), and the American College of Clinical Pharmacy. Dr. Dager currently serves as an instructor and regional affiliate faculty in advanced cardiac life support (ACLS) for the American Heart Association.
Dr. Dager serves as a reviewer and editorial board member for several medical journals. He is currently chairman of the Editorial Advisory Board Panel on Anticoagulation for Annals of Pharmacotherapy. He is also a 2008 site coordinator for the ASHP Foundation’s anticoagulation preceptorship.
Dr. Dager has authored numerous articles, book chapters, and scientific reviews and has presented at national and international educational conferences. He is the recipient of multiple teaching awards, is an active lecturer; and is involved in several research projects in the areas of anticoagulation, critical care medicine, cardiovascular disease, pharmacokinetics, and pharmacodynamics.

Michael P. Gulseth, Pharm.D., BCPS
Program Director for Anticoagulation Services
Department of Pharmaceutical Services
Sanford USD Medical Center
Sioux Falls, South Dakota

Michael P. Gulseth, Pharm.D., BCPS is Program Director for Anticoagulation Services at the Sanford University of South Dakota Medical Center, Department of Pharmaceutical Services in Sioux Falls, South Dakota. Dr. Gulseth received his Doctor of Pharmacy degree in 1999 from North Dakota State University in Fargo, North Dakota. He completed residency training at United Hospital in St. Paul, Minnesota. He is lead author and editor of Managing Anticoagulation Patients in the Hospital: the Inpatient Anticoagulation Service, published in 2007 by the American Society of Health-System Pharmacists.

Dr. Gulseth is a member of the Editorial Advisory Board of the American Journal of Health-System Pharmacy. Dr. Gulseth is an active member of several professional pharmacy organizations, including the American Society of Health- System Pharmacists, the Minnesota Society of Health-System Pharmacists, the South Dakota Society of Health-System Pharmacists, and the American College of Clinical Pharmacy. His research interests include evaluation of antithrombotic therapies in the inpatient setting and evaluation of the benefits of pharmacist managed inpatient anticoagulation services.

Edith A. Nutescu, Pharm.D., FCCP,
 
Edith A. Nutescu, Pharm.D., FCCP, is Clinical Professor in the Department of Pharmacy Practice and Center for Pharmacoeconomic Research at the University of Illinois at Chicago College of Pharmacy. She also serves as the Clinical Manager of the Antithrombosis Center at the University of Illinois at Chicago Medical Center. Dr. Nutescu earned her Pharm.D. degree with high honors at the University of Illinois at Chicago College of Pharmacy. After graduation, Dr Nutescu went on to complete an American Society of Health-System Pharmacists (ASHP)–accredited Pharmacy Practice Residency at Lutheran General Hospital–Advocate Health Care and a Primary Care Specialty Residency at the University of Illinois at Chicago Medical Center.  

As a clinician and educator, Dr. Nutescu has contributed extensively to the care of patients and the education of students and health care providers on topics related to cardiovascular therapeutics. Dr. Nutescu maintains an active clinical practice and research program. Her research and practice interests are in the areas of comparative effectiveness, health services and outcomes, with emphasis in cardiovascular diseases, stroke, thrombosis, and antithrombotic therapies.

Dr Nutescu has authored or co-authored over 100 scientific articles, book chapters, and abstracts published in the science and medical literature and has served as a reviewer for the literature in her field. Dr. Nutescu’s research has been funded by the Department of Health and Human Services and the National Center for Research Resources and is a recipient of the Ruth L. Kirchstein National Research Service Award for 2009-2011. Dr. Nutescu is the recipient of the American College of Clinical Pharmacy’s 2009 Clinical Practice Award and the American Society of Health System Pharmacists, Section of Home and Ambulatory Care Practitioners 2010 Distinguished Service Award.

 

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Table of Contents


Anticoagulation Therapy Table of Contents
Foreword
Preface
Contributors
Abbreviations

PART I: Anticoagulant Medication Management
1. Introduction
2. Warfarin (Ann Wittkowsky)
3. Unfractionated Heparin (William Dager)
4. Low molecular weight heparin and fondaparinux (Edith Nutescu)
5. Direct thrombin inhibitors (William Dager)
6. Thrombolytics (Toby Trujillo)
7. Anticoagulation reversal (John Dougherty)
8. Transitions in care, periprocedural bridging and transitions between agents (John Fanikos)
9. Late development, pipeline and emerging anticoagulants (Ann Wittkowsky)
PART II: Conditions Requiring Anticoagulation Therapy
10. Venous thromboembolism prevention (Paul Dobesh and Zach)
11. Venous thromboembolism treatment (Diagnosis of VTE to be included in this chapter) (Mike Gulseth)
12. Atrial fibrillation
13. Acute coronary syndromes (Sarah Spinler)
14. Prosthetic heart valves (Douglas Anderson)
15. Heparin induced thrombocytopenia (Dan Witt)
16. Pregnancy (Nancy Shapiro)
17. Pediatrics (Kirsten Ohler)
PART III: Practical Monitoring and Coagulation Laboratory Insights
18. Coagulation laboratory considerations (Robert Gosselin, Maureen Smythe)
19. Hypercoagulabity evaluation and testing (Jessica Michaud)
20. Miscellaneous anticoagulation related clinical issues (maybe be deleted or become appendix)
Index

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