Anticoagulant Therapy

Idarucizumab for Dabigatran Reversal Approved

On Friday, October 16, the FDA approved idarucizumab (Praxbind) as an effective reversal agent for the oral direct thrombin inhibitor, dabigatran (Pradaxa). Click here tor the press release. Thanks to Dr. Paul Riley, Stago-US, for this heads-up.

Anticoagulant Therapy

Collecting Heparin Assay Specimens from a Device

Dear George Fritsma, I work at The Valley Hospital in Ridgewood N.J. and our nursing staff has the following question about drawing an APTT from a central line/picc line when heparin is infusing. Is there a protocol of how long to stop the infusion? Also, should the first syringe be discarded? I am interested in knowing […]

Anticoagulant Therapy

USE DDAVP for Plavix Overdose

George is teaching a graduate hemostasis course for Michigan State University. In a chat room today, a participant asked if DDAVP may be used to reverse bleeding in a patient with a Plavix overdose. One of our students is a 15-year Hem-Onc who said this was an accepted ER approach. Does your facility also use […]

Anticoagulant Therapy

Platelet Count and POC PT/INR

A participant asks if point of care PT/INR results are affected by the platelet count. George responds that POC PT/INR instrument package inserts list no effects related to thrombocytopenia or thrombocytosis. Documented interferences include specimen management errors that result in partial preanalytical clotting, foaming, or hemolysis; hematocrit below 20% or above 55%, presence of coagulopathies […]

Anticoagulant Therapy

Heparin Therapeutc Range

From Keith DeHaas, Southwestern Vermont Healthcare: Hi George I am currently enrolled in BLD 835 and am thoroughly enjoying the class. I have a question about sourcing specimens of plasma with unfractionated heparin for use in ex vivo Xa studies. We are a small hospital that does not use much heparin and getting enough heparinized […]

Anticoagulant Therapy

Anti-Xa Nomenclature

FF Participants, the PTT versus Anti-Xa entry has morphed into a discussion of anti-Xa nomenclature, so I’ve decided to start a new thread. Be sure to link back to the prior thread to see where this is coming from. From Dr. Favaloro: Couldn’t resist adding my support to this. We have moved away from “anti-Xa” […]

Anticoagulant Therapy

Idarucizumab for Dabigatran Reversal

Some recent news about dabigatran reversal, a report on the REVERSE-AD study, is reported in The Heart.Org.

Anticoagulant Therapy

PTT Versus Anti-Xa

For several years, most coagulation specialists have supported using the chromogenic anti-Xa assay in place of the PTT for monitoring unfractionated heparin therapy. We contend the anti-Xa is more accurate and reproducible as it is less prone to interference. Many medical center laboratories have converted to the anti-Xa as their primary means for monitoring UFH, […]

Anticoagulant Therapy

Lovenox Causes Urinary Tract Bleeding

George received this message from Prof. Emerita Bernadette (Bunny) Rodak, editor and author of Rodak’s Hematology: Clinical Principles and Applications. Bunny has an ovarian tumor accompanied by some clotted abdominal vessels, and has been receiving 120 mg of Lovenox once a day. She has experienced bleeding after each dosage and had asked whether she could […]

Anticoagulant Therapy

Stable Dabigatran Levels in Anticoagulation Clinic Patieents

This abstract was presented as a poster at the American Society for Clinical Laboratory Science annual meeting, Atlanta, July, 2015: McGlasson DL, Fritsma GA. Stable Dabigatran Levels in Anticoagulation Clinic Patients: An Unexpected Finding. Clin Lab Sci 2015; 28:159. The dabigatran effect is rapid. Its half-life is 12–17 hours. Experts believe missed doses may lead […]

Anticoagulant Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

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