Effect of dabigatran on referrals to and switching from warfarin in two academic anticoagulation management services.

Dabigatran was expected to replace warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF) who are warfarin naive, difficult to maintain in therapeutic range, or at risk of warfarin-related bleeding complications. We hypothesized that the number of patients with nonvalvular AF referred to Anticoagulation Management Services would decrease sharply and that most would switch from warfarin to dabigatran. We evaluated the number of patients with nonvalvular AF referred to 2 large services, Anticoagulation Management Service 1 and Anticoagulation Management Service 2, 12 months before and after market entry of dabigatran.

Digoxin: clinical highlights: a review of digoxin and its use in contemporary medicine.

Digoxin is the oldest cardiac medication used in contemporary medicine. With a complex pharmacokinetic profile and narrow therapeutic index, its use in managing patients with atrial arrhythmias or heart failure can present a challenge to today's clinicians. Digoxin dosing based on patient-specific factors such as age, lean body weight, and renal function will allow practitioners to minimize drug toxicity while maintaining clinical efficacy.

Efficacy and safety of novel anticoagulants compared with established agents.

Dabigatran, rivaroxaban, and apixaban are novel oral anticoagulants that offer major advantages over existing agents. The onset of the anticoagulant effect of these agents is rapid. Each agent has a predictable anticoagulant response that eliminates the need for monitoring.

Dronedarone: a review of characteristics and clinical data.

Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular mortality, stroke, and hospitalization in the United States. Amiodarone is generally considered as the agent with the best efficacy for maintaining normal sinus rhythm. Despite its efficacy, amiodarone use is often limited by its extensive side effect profile.