29 January 2015 (Thursday) - Apixaban

      Here’s something out of the ordinary….. coag results seem to be to pot.    

                   Specimen Results Entry

                                      29/01/2015 18:00
DASTARDLY, DICK   06/01/1935   Male     000000            Emergency Care Centre
1 The Street Folkestone                   Dr
SOB, large pleural effusion, metabolic acidosis.On    U         HAWK
Specimen No   :  AK681632H               Selected Auth Level : S
--------------------T-------------------T-------------------T-------------------
 PT     31.3   F000 |                   |                   |
 APTT   47.5   F000 |                   |                   |                    |                   |                   |
                    |                   |                   |
--------------------T-------------------T-------------------T-------------------
LTG comments : CS,CX,CXR,DIC,EXT,IA,INT,ITS,LUPUS,PTT,RM,TS,TSW,VWF


 1 Auth'd   2 Unauth'd   3 Nomin'd   4 Change   5 Reject  6 Options  7 eXit> U
 




                   Specimen Results Entry

                                      29/01/2015 18:00
DASTARDLY, DICK   06/01/1935   Male     000000            Emergency Care Centre
1 The Street Folkestone                   Dr
Specimen No   :  AK681632H               Selected Auth Level : S

Specimen No   :  AK681632H               Selected Auth Level : S
--------------------T-------------------T-------------------T-------------------
 PT     31.3   F000 |                   |                   |
 PT50   17.0   F008 |                   |                   |
 APTT   47.5   F000 |                   |                   |
 APTT50 34.3   F008 |                   |                   |
 APTTR ^1.6    F008 |                   |                   |
 INR    2.2    F000 |                   |                   |
 FIB    2.91   F008 |                   |                   |
 TT     20.7   F008 |                   |                   |
                    |                   |                   |
                    |                   |                   |
--------------------T-------------------T-------------------T-------------------
LTG comments : CS,CX,CXR,DIC,EXT,IA,INT,ITS,LUPUS,PTT,RM,TS,TSW,VWF


 1 Auth'd   2 Unauth'd   3 Nomin'd   4 Change   5 Reject  6 Options  7 eXit> U

Further testing doesn’t really throw us any bones at first sight… is the patient on anticoagulants?

                   Specimen Results Entry

                                      29/01/2015 18:00
DASTARDLY, DICK   06/01/1935   Male     000000            Emergency Care Centre
1 The Street Folkestone                   Dr
SOB, large pleural effusion, metabolic acidosis.On    U         HAWK
Specimen No   :  AK681632H               Selected Auth Level : S

------T-----------------------------------------------------------------------]
  Date|29/01/2015 20/09/2014 19/09/2014 20/11/2012 14/11/2012 13/11/2012      |
  Time|18:00      u/k        u/k        u/k        09:30      09:45           |
  Spec|AK681632H  AW195849Z  AW195351J  AW222189T  AW206838M  AW201661M       |
      |BIO        BIO        BIO        BIO        BIO        BIO             |
Test--+-----------------------------------------------------------------------{
PT    |31.3       18.0       17.3                                             |
PT50  |17.0                                                                   |
APTT  |47.5       39.9       37.4                                             |
APTT50|34.3                                                                   |
APTTR |^1.6       ^1.3       ^1.2                                             |
INR   |2.2        1.2        1.2        7.2        2.4        2.1             |
FIB   |2.91                  4.91                                             |
TT    |20.7                  16.3                                             |
      |                                                                       |

------T-----------------------------------------------------------------------]
  1 View   2 Graph   3 eXit  X
                                                                       More >>


 But look at the history… those INRs. Warfarin?

The patient was actually taking apixaban – a factor Xa inhibitor prescribed for treatment and secondary prophylaxis of DVT and PE.

A new one on me...






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