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Spinal Anesthesia in Elderly Patients With Femoral Neck Fractures on Apixaban Therapy: A Case Series.
A A Pract
January 2025
From the Department of Anesthesiology, Sheba Medical Center, Ramat Gan, Israel.
This case series reviews surgeries involving elderly patients with femoral neck fractures on apixaban who underwent spinal anesthesia (SA) within 72 hours of their last dose. Despite patients being on anticoagulation, no neurological complications occurred, suggesting SA may be practical in cases where the benefits of timely surgery outweigh the potential risks, including apixaban discontinuation for a period of less than the recommended 72 hours with detectable levels of the drug remaining in the plasma. Quantitative apixaban measurements offered useful anticoagulation status insights, though safe thresholds remain undefined.
View Article and Find Full Text PDFImpact of Apixaban Lead-In Therapy Duration After Parenteral Anticoagulation on Bleeding in Patients Treated for Venous Thromboembolism.
J Pharm Pract
January 2025
Department of Pharmacy, Veterans Affairs Hospital, Memphis, TN, USA.
Venous thromboembolism (VTE) treatment with apixaban uses a higher 10 mg twice daily regimen for 7 days (lead-in therapy). But, in patients with initial parenteral anticoagulation treatment or those with higher bleeding risk, clinicians may not always adhere to the full 7-day lead-in duration. This retrospective cohort study included adult patients admitted to the Veterans Affairs Health care System from January 2011 to April 2022, who received at least 24 hours of parenteral anticoagulation followed by lead-in apixaban therapy for VTE.
View Article and Find Full Text PDFDirect oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.
EuroIntervention
January 2025
Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Background: The role of direct oral anticoagulants (DOACs) in the treatment of left ventricular thrombus (LVT) after ST-elevation myocardial infarction (STEMI) remains uncertain.
Aims: We aimed to compare the effect of rivaroxaban versus warfarin in patients with STEMI complicated by LVT.
Methods: Adult patients with STEMI and two-dimensional transthoracic echocardiography showing LVT were assigned to rivaroxaban (15 mg once daily) or warfarin (international normalised ratio goal of 2.
A newly developed high-performance thin layer chromatographic method for determination of remdesivir, favipiravir and dexamethasone, in spiked human plasma: comparison with the published methods.
BMC Chem
January 2025
Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Co-administration of COVID-19 RNA polymerase inhibitors, remdesivir and favipiravir, has synergistic benefits. Together they reduce viral load and inflammation more effectively than either drug used alone. Corticosteroids like dexamethasone are used alongside antivirals in multidrug combination regimens.
View Article and Find Full Text PDFSystemic Embolism and Clinically Significant Bleeding Events in Older Adults with Nonvalvular Atrial Fibrillation After Treatment with Direct Oral Anticoagulants and Warfarin: A Retrospective Cohort Study in Japan.
Pharmaceutics
November 2024
Laboratory of Regulatory Science, Faculty of Pharmacy, Musashino University, Nishi-tokyo, Tokyo 202-8585, Japan.
Anticoagulant therapy, particularly the use of direct oral anticoagulant agents (DOACs), is recommended for patients with nonvalvular atrial fibrillation (NVAF). This multicenter observational retrospective cohort study aimed to assess the efficacy and safety of DOACs compared to warfarin in Japanese patients aged 75 years and older with NVAF. Data from the Mie-Life Innovation Promotion Center Database were used to collect medical information on the patients.
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