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The Fellow on Call: The Heme/Onc Podcast
New Fellow Bootcamp Series: When Anticoagulation Fails (part 2)
Jul 3, 2024
Dive into the complexities of anticoagulation failures and discover alternative strategies when conventional treatments falter. Explore the challenges faced by patients on warfarin, including diagnosing new clots and the importance of imaging. Learn about managing anticoagulation in conditions like antiphospholipid antibody syndrome, with a focus on diagnostic testing and INR interpretation. The podcast also emphasizes tailored Lovenox dosing and monitoring drug levels to tackle breakthrough thrombotic events. It's a blend of medical insights and a delightful sandwich shop interlude!
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Quick takeaways
- Accurate assessment of anticoagulation therapy failure in patients requires distinguishing between new and residual clots to tailor management effectively.
- Pre-filling anticoagulant syringes can lead to dosing inconsistencies, necessitating careful monitoring of anti-Xa levels for optimal treatment outcomes.
Deep dives
Understanding Anticoagulation Failure
The discussion focuses on what to do when anticoagulation therapy, such as warfarin or injectables, fails in patients. A case study of a 36-year-old man with antiphospholipid antibody syndrome illustrates that his INRs were within the therapeutic range, yet imaging revealed a clot. The importance of determining whether this clot was new or residual from previous treatments is emphasized. This distinction guides clinicians to evaluate the therapeutic efficacy of anticoagulants and consider that patients with significant medical histories may require tailored approaches to management.
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Discover
highlights
Listen to the best highlights from the podcasts you love and dive into the full episode