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Maybe Pradaxa (dabigatran) does need blood monitoring after all
2.5 out of 5 stars The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients. Reilly PA et al. J Am Coll Cardiol 2014 Feb 4;63:321-8. Abstract A must-read article in yesterday’s New York Times described the internal battle at Boehringer Ingelheim, the maker of Pradaxa (dabiagtran etexilate), concerning the publication of this study. A major marketing point posited in favor of dabigatran over warfarin for the prevention of stroke in patients with atrial fibrillation was that it did not require monitoring with reg...
Source: The Poison Review - February 7, 2014 Category: Toxicology Authors: Leon Tags: Medical bleeding blood testing boehringer ingelheim dabigatran pradaxa stroke Source Type: news

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

What Extreme Heat Does to the Human Body
For the third weekend in a row, large swaths of the United States have wilted under early-season heatwaves that have set high temperature records from California to Texas. Nearly 100 million Americans are facing heat warnings and advisories from the southwest to the Mississippi River, with temperatures spiking well into the triple digits in California, Texas, Arizona, and Colorado. As much of the northern hemisphere heads into what is projected to be a hotter-than-usual summer, more people will be exposed to dangerous levels of high heat and humidity. Heatwaves kill more people annually in the U.S. than hurricanes, lightni...
Source: TIME: Health - June 13, 2022 Category: Consumer Health News Authors: Aryn Baker Tags: Uncategorized climate change Climate Is Everything Explainer extreme weather healthscienceclimate Londontime overnight Source Type: news

Fatal dabigatran toxicity secondary to acute renal failure
We describe the case of a 74-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation who presented to the emergency department after 20 mL of hematemesis at home. Laboratory evaluation revealed a partial thromboplastin time of 99 seconds, international normalized ratio of 11.7, and creatine of 3.1 mg/dL (baseline creatine, 0.9 mg/dL). Upper endoscopy revealed diffuse gastritis and bleeding. Despite treatment with packed red blood cells and fresh frozen plasma, the patient's hematemesis persisted resulting in significant aspiration requiring endotracheal intubation. Per poison control center recommendation...
Source: The American Journal of Emergency Medicine - November 19, 2012 Category: Emergency Medicine Authors: Joseph K. Maddry, Mana Kouros Amir, Daniel Sessions, Kennon Heard Tags: Case Reports Source Type: research

Case report: hemodialysis for dabigatran overdose
3 out of 5 stars Hemodialysis for the Treatment of Pulmonary Hemorrhage from Dabigatran Overdose. Chen BC et al. Am J Kidney Dis 2013 Apr 15 [Epub ahead of print] Abstract Dabigatran (Pradaxa) is a competitive direct thrombin inhibitor approved in the United States for stroke prophylaxis in patients with nonvalvular atrial fibrillation. Although dabigatran has certain advantages over coumadin related to issues of dosing and testing, there is no readily available test to measure its anticoagulation effect, and there is no antidote to reverse bleeding. Recommendations for treating a patient with dabigatran-associated hemorr...
Source: The Poison Review - April 24, 2013 Category: Toxicology Authors: Leon Tags: Medical dabigatran hemodialysis hemorrhage overdose Source Type: news

Health status of populations living in French overseas territories in 2012, compared with metropolitan France: An analysis of the national health insurance database.
CONCLUSION: This study highlights the utility of administrative database to compare and follow population health status considering healthcare use. Specific Public Health policies are justified for FOT, taking into account the specific context of each FOT, the necessity of prevention initiatives and screening to reduce the frequency of the chronic diseases. PMID: 27238162 [PubMed - as supplied by publisher]
Source: Revue d Epidemiologie et de Sante Publique - May 31, 2016 Category: Epidemiology Tags: Rev Epidemiol Sante Publique Source Type: research

French Intensive Care Society, International congress - Réanimation 2016.
C, Sauneuf B, Verrier P, Pottier V, Orabona M, Samba D, Viquesnel G, Lermuzeaux M, Hazera P, Hanouz JL, Parienti JJ, Du Cheyron D, Demoule A, Clavel M, Rolland-Debord C, Perbet S, Terzi N, Kouatchet A, Wallet F, Roze H, Vargas F, Guérin C, Dellamonica J, Jaber S, Similowski T, Quenot JP, Binquet C, Vinsonneau C, Barbar SD, Vinault S, Deckert V, Lemaire S, Hssain AA, Bruyère R, Souweine B, Lagrost L, Adrie C, Jung B, Daurat A, De Jong A, Chanques G, Mahul M, Monnin M, Molinari N, Lheureux O, Trepo E, Hites M, Cotton F, Wolff F, Surin R, Créteur J, Vincent JL, Gustot T, Jacobs F, Taccone FS, Neuville M, Timsit JF, El-Hel...
Source: Australian Family Physician - May 31, 2016 Category: Primary Care Authors: Jaillette E, Girault C, Brunin G, Zerimech F, Chiche A, Broucqsault-Dedrie C, Fayolle C, Minacori F, Alves I, Barrailler S, Robriquet L, Delaporte E, Thellier D, Delcourte C, Duhamel A, Nseir S, Valette X, Desmeulles I, Savary B, Masson R, Seguin A, Daubi Tags: Ann Intensive Care Source Type: research

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news