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In this episode, I discuss a medication known as dabigatran (Pradaxa). I cover mechanism of action, precautions, contraindications, dosing, and side effects.

Welcome back to drug talk everybody in today’s video we’re going to be going over all the information that you really need to know about dabigatran or pradaxa so dabigatrain and its active metabolites are competitive direct thrombin inhibitors which prevent thrombus development now before somebody was to use this medication or be given this medication there are

Some precautions that the medical team or the patient should be made aware of first off this medication is on the beers criteria which is the list of medication that the elderly population should either avoid or use cautiously we would want to avoid giving this medication to elderly patients with a creatinine clearance less than 30 milliliters per minute due

To a lack of evidence in terms of efficacy and safety also we would want to use this medication very cautiously again or avoid it in patients over the age of 75 due to an increased risk of gastrointestinal bleeding when compared to warfarin significant and potentially fatal bleeding has been reported this is more common in elderly patients or patients in the

Labor and delivery unit and it’s actually also more common in patients that are also using other medications that may increase the risk of bleeding such as anti-platelet drugs heparin or nsaids also known as non-steroidal anti-inflammatory drugs in all of these situations monitoring would of course be recommended and the bigger trend will be stopped in the event

Of pathological bleeding for patients using this medication who have renal or kidney impairment there would be an increased risk of bleeding in these patients this is mainly caused by an increased exposure to the medication dose adjustment or discontinuation of the bigger trend is recommended in this situation patients and health teams should also be aware that

Invasive or surgical procedures would increase the risk of bleeding so the bigger trend should be stopped or the benefit versus risk should be weighed carefully now once somebody is made aware of the precautions and they’re cleared of them there are also some contraindications that they should be made aware of as well if they have any of these contraindications

They would not use the bigatran it would be contraindicated in a patient who has active pathological bleeding patients with a medical prosthetic heart valve would not use this medication and of course like most medications if a patient had a hypersensitivity reaction in the past they would not use the bigatron once the patient has cleared up the contraindications

Our next concern is how is this medication dosed so the dosing of this medication really comes down to the indication what is being treated with the bigatran for example with most cases surrounding atrial fibrillation to prevent cardiovascular accidents we would typically see 150 milligrams given twice daily another example would be if somebody was having a total

Hip replacement and we were trying to give this medication for post-operative deep vein thrombosis prevention they may get 110 milligrams a couple hours after the surgery and then use 220 milligrams for about 28 to 35 days so once somebody starts using this medication the next thing they should be concerned of that we’re going to talk about here is side effects

Less than one percent of patients may experience a heart attack or myocardial infarction using this medication a gastrointestinal hemorrhage may happen up to 1.6 percent of the time but again depending on what indication is being treated and what dose you’re receiving some patients may experience upper gastrointestinal bleeding or anaphylaxis like we mentioned

Some patients may experience an epidural hematoma an intracranial hemorrhage may happen 0.3 percent of the time and lastly some patients may as well experience alveolar hemorrhages that’s all we’re going to discuss today about the bigger trend or pradaxa in this video but before you go i wanted to quickly let you know that you can pick up a copy of my new book the

Fifth episode inside the manic mind by clicking on the link in the description of this video take care

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