BARNES, HEDWARD 06:38
MR
20/08/1940 Male 654321 Emergency Care Centre
Specimen No : AK564330X Haematology & Chemistry
03/04/2015 06:38
Citrated Blood
Request
Reason : chest pain
PT 20.4 s ( 12 to 16 ) Auth
APTT 51.3 s ( 22.0 to 35 ) Auth
APTT
Ratio ^1.8 Auth
I.N.R. 1.4 Auth
Coag
Screen
LTG
Comments :
Patient
is on dabigatran
|
Dabigatran (Pradaxa or
Prazaxa) is an oral anticoagulant acting as a direct thrombin inhibitor. It
is being trialled for various clinical indications and is claimed to offer an
alternative to warfarin as the preferred orally administered anticoagulant since
it does not require INR monitoring while offering similar results in terms of
efficacy.
There is no specific way to reverse the anticoagulant effect
of dabigatran in the event of a major bleeding event unlike warfarin although a
potential dabigatran antidote (pINN: idarucizumab) is undergoing clinical
studies.
It was developed by the pharmaceutical company Boehringer Ingelheim…
on July 26, 2014, the British Medical Journal (BMJ) published a series of
investigations that accused Boehringer of withholding critical information
about the need for monitoring to protect patients from severe bleeding,
particularly in the elderly.
Reviews of internal communications between Boehringer
researchers and employees, the FDA and the EMA revealed that Boehringer
researchers found evidence that serum levels of dabigatran vary widely. The BMJ
investigation suggested that Boehringer had a financial motive to withhold this
concern from regulatory health agencies because the data conflicted with their
extensive marketing of dabigatran as an anticoagulant that does not require
monitoring.
I can’t help but wonder how many other “wonder drugs” aren’t quite so wonderful. Perhaps if they weren’t
quite so lucrative…?
