Anticoagulant Therapy

Familial Thrombosis Case

George received this question on June 28, 2020, and has secured permission to post here while withholding the correspondent’s identity. Hello, and thank you for the Fritsma Factor. Our family is of Eastern Europe parentage and we have a genetic clotting family history. Several occurences have shown up at age 28 after a preceeding event. […]

Anticoagulant Therapy

More on the DOAC Dipstick

Please refer to our May 6, 2020 entry, “Detecting DOACs in Urine,” regarding the DOAC Dipstick®. Dr. Favaloro has given permission to post his editorial here. Please click or tap Favaloro E, Lippi G. The pointy end of point of care testing for direct oral anticoagulants. Thromb Haemost 2020: 120: 11–13. This product shows great […]

Anticoagulant Therapy

More on Covid and LAC

Thanks to Dr. Ali Sadeghi-Khomami, Precision BioLogic Inc., for sending a current editorial in press, Aubignat M, Godefroy O. COVID-19 and ischemic stroke: Should we systematically look for lupus anticoagulant and antiphospholipid antibodies? Revue neurologique 2020, https://doi.org/10.1016/j.neurol.2020.05.001. Please refer to our May 6 entry on antiphospholipid syndrome and the comment from Dr. Ning Tang. The […]

Anticoagulant Therapy

Covid and Hemostasis

On April 22, the Washington Post published an informative and alarming article on the relationship between Covid infection and hemostatic abnormalities. Critical Covid cases involve sepsis and abnormal hemostasis, primarily venous thromboembolic disease. The most current and authoritative resources for VTE management are the American Society of Hematology Covid Q&A site, https://lnkd.in/eDeurb7, and the Anticoagulation […]

Anticoagulant Therapy

AC Clinics and Covid-19

The Anticoagulation Forum conducted a webinar on Wednesday, March 25 entitled Management of Warfarin Patients Who Have Difficulty Getting INR Testing During COVID-19 Pandemic. Click or tap the title to see the recorded presentation, which centers on Warfarin management. Here are a few takeaways from the webinar, please feel free to add your observations below. […]

Anticoagulant Therapy

Detecting DOACs in Urine

George has been in touch with long-time colleague and friend, Jeanine Walenga, PhD, Loyola University Medical Center. Dr. Walenga collaborates with Dr. Job Harenberg of DOASENSE® in development of the DOAC Dipstick®, a qualitative urine immersion strip that detects a DOAC within ten minutes. A pad for the thrombin inhibitor dabigatran and a pad for […]

Anticoagulant Therapy

Coumadin Therapy: Molecular Screens?

George is preparing updates for several of our Educational Modules and is currently revising the Coumadin (Warfarin) module of the Antithrombotic Therapy series. While DOAC therapy is rapidly replacing Coumadin as the mainstay for stroke prevention in non-valvular atrial fibrillation and for prophylaxis following total hip and knee replacement surgery, Coumadin is still in everyday […]

Anticoagulant Therapy

November, 2019 Quick Question

Our November, 2019 Quick Question asked, “What may you substitute for the PT when LAC prolongs the PT?” We accumulated 53 votes. A. None, use the PT anyway: 9% (5) B. Chromogenic anti-Xa: 13% (7) C. Chromogenic factor X: 30% (16) D. Activated clotting time: 8% (4) E. Thrombin time: 11% (6) F. There is […]

Anticoagulant Therapy

Switching from DOAC to UFH

From Maureen Tacke, Program Manager, Lab, Hematology/Coagulation, St. Luke’s Health System: Our institution is working towards a conversion to Anti-Xa monitoring for patients on UFH, however, our pharmacy group has a question. What are other facilities doing if a patient presents, needs UFH, and is already on a DOAC (the baseline anti-Xa or PTT is […]

Anticoagulant Therapy

Quick Question: PT substitute

Our November, 2019 Quick Question asks, “What may you substitute for the PT when LAC prolongs the PT?” This question addresses the unreliability of the PT for monitoring Coumadin therapy when lupus anticoagulant interferes by prolonging the result. It is also relevant to PT prolongation by fibrinogen deficiency or factors II, V, VII, or X […]

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.

Cheat Sheets from George

Quick Question