Donna Barakeh, Kevin R Donahue, Mahmoud Sabawi, Diane Dreucean
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引用次数: 0
Abstract
Purpose: This case series explores the use of thrombin time (TT) to transition 2 patients from dabigatran to unfractionated heparin (UFH) in the setting of acute kidney injury (AKI) and coagulopathy concerning for dabigatran accumulation.
Summary: Serial TT monitoring was employed until the value began to trend below 120 seconds, indicating ongoing drug clearance, at which point UFH was initiated. Patient 1 experienced rectal bleeding following initiation of UFH, while patient 2 experienced hemoglobin drops without an apparent bleeding source. No thrombotic events occurred during either hospitalization.
Conclusion: Individualized management remains paramount to balance bleeding and thrombotic risk based on patient-specific factors. Further research is warranted to validate the safety and efficacy of a TT-guided transition strategy and optimize protocols for hospitalized patients transitioning from dabigatran to UFH.
期刊介绍:
The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.