This flashcard is just one of a free flashcard set. See all flashcards!

● Oral anticoagulants are deployed in patients with atrial fibrillation based on a risk factor score, the simplest of which is CHADS2 (chronic heart failure, hypertension, age >75 years, diabetes, stroke).
● Give a loading dose (usually 3 average daily doses) of warfarin/phenprocoumon simultaneously with a standard s.c. dose of a low molecular weight heparin. Reduce and further adjust warfarin/phenprocoumon upon daily INR measurements until similar INR values within the target range of 2.0-3.0 have been measured on two consecutive days. Discontinue heparin at INR>2.0.
● Thereafter determine INR every 3 weeks in every warfarin/phenprocoumon-treated patient and more frequently upon any co-medication changes or after INR value derangements.
● Make sure that warfarin/phenprocoumon-treated patients understand why they must not commence, interrupt, or dose-adjust any concomitant treatment without consulting a physician.
● New oral anticoagulants such as rivaroxaban are similarly effective, cause less bleedings, and require no monitoring. Due to the high cost they are currently prescribed mostly to patients with frequent INR derangements.