INPATIENT ANTICOAGULATION

The first practical guide for hospitalists on the use of anticoagulants in hospitalized patients

This edited volume provides a comprehensive overview of the vital topic of anticoagulation in the hospital setting. Designed specifically for use by hospital-based clinicians and associated hospital-based staff, this fully evidence-based book addresses the most commonly used anticoagulant agents, the latest advances in anticoagulation drugs, and primary indications for their use at therapeutic levels.

This thorough, easy-to-use reference summarizes the most important guidelines and medical literature on anticoagulation. It features a careful review of the epidemiology and treatment of complications associated with anticoagulants. Unique topics include transition of care and practical strategies for developing and implementing quality improvement programs to enhance the administration and safety of anticoagulants.

This concise resource also covers:

• Antiplatelet medications

• The treatment and prevention of venous thromboembolism in medical patients

• Venous thromboembolism prophylaxis in surgical patients

• Peri-operative management of oral anticoagulants and antiplatelet agents

• Prevention of cardioembolic stroke

• Antithrombotics for ischemic stroke

• Antithrombotic therapy for non-ST elevation acute coronary syndrome

• Hemorrhagic complications of anticoagulants in hospitalized patients

• Heparin-induced thrombocytopenia

Hospitalists and other members of the patient care team will find that Inpatient Anticoagulation answers their questions with dependable and timely information.

Margaret C. Fang, MD, MPH, is an academic hospitalist and assistant professor of medicine at the University of California, San Francisco. Her research interest is in how best to prevent stroke in older patients with atrial fibrillation. In particular, her goals are to explore clinical and biological risk factors for stroke, identify the optimal use of anticoagulants to prevent atrial fibrillation-related stroke, and direct attention toward social and behavioral barriers to optimal anticoagulant management. Eventually, she would like to develop interventions directed at improving clinical decision-making regarding anticoagulation therapy for the oldest patients.
Dr. Fang trained in internal medicine at the Beth Israel Deaconess Medical Center in Boston and subsequently completed a research fellowship at Massachusetts General Hospital, obtaining a Masters of Public Health. She joined the staff at UCSF in 2003, where she is a practicing hospitalist as well as a clinician-investigator. She is currently part of the ATRIA Study Group, an NIA-funded study of warfarin use and outcomes in a large cohort of patients with atrial fibrillation.

ContentsPreface viiContributors ix1. Pharmacology of Parenteral Anticoagulants 1Kathleen H. McCool and Daniel M. Witt2. Pharmacology of Vitamin K Antagonists 25Jaekyu Shin and Steven R. Kayser3. Antiplatelet Medications 47Michael Kornfeld and Joseph R. Munsayac4. Newer Oral Anticoagulants 67Taki Galanis and Geno J. Merli5. Prevention of Venous Thromboembolism in Medical Patients 81Alex C. Spyropoulos and Charles E. Mahan6. Prevention of Venous Thromboembolism in Surgical Patients 107Nancy Torres Finnerty and Franklin Michota7. Treatment of Acute Venous Thromboembolism in HospitalizedPatients 137Tracy Minichiello, Lauren Doctoroff, and Elizabeth A. Farrell8. Perioperative Management of Oral Anticoagulants andAntiplatelet Agents 161Ramiro Jervis and Andrew Dunn9. Prevention of Cardioembolic Stroke 179Ali Mahajerin and Warren J. ManningvFang ftoc.tex V1 - 04/23/2011 3:09 P.M. Page vivi Contents10. Antithrombotics for Ischemic Stroke 205Fadi B. Nahab and Sakib Qureshi11. Antithrombotic Therapy for Non-ST-Elevation Acute CoronarySyndrome 223David Lao and Andrew Boyle12. Parenteral Anticoagulants: Special Considerations in Patientswith Chronic Kidney Disease and Obesity 241Sarah A. Spinler, Millie Rajyaguru, Julie K. Atay, and John Fanikos13. Hemorrhagic Complications of Anticoagulants in HospitalizedPatients 291Allison Burnett, Jason Cohen, and David A. Garcia14. Heparin-Induced Thrombocytopenia 331David Feinbloom and John Fani Srour15. Transitions in Care: Inpatient Anticoagulation 361Neil Gupta, Diane Sliwka, and Margaret C. Fang16. Optimizing Inpatient Anticoagulation: Strategies for QualityImprovement 377Greg Maynard, Ian Jenkins, Brian Clay, Michael Montazeri, andDoug HumberIndex 415