Skip main navigation

PharmacotherapyFirst: A Multimedia Learning Resource

Quick Facts

  • 1. Beckman MG, Hooper WC, Critchley SE, et al. Venous thromboembolism: a public health concern. Am J Prev Med. 2010 Apr;38(4 Suppl):S495–501. Crossref, MedlineGoogle Scholar,
  • 2. Blood clots. MedlinePlus. Bethesda, MD, National Library of Medicine. Available at: https://medlineplus.gov/bloodclots.html? Updated April 21, 2021. Google Scholar,
  • 3. Venous thromboembolism in adult hospitalizations—United States, 2007–2009. MMWR Morb Mortal Wkly Rep. 2012;61:401–404. MedlineGoogle Scholar,
  • 4. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation. 2023 Feb 21;147(8):e93–e621. doi:10.1161/CIR.0000000000001123. Epub 2023 Jan 25. Erratum in: Circulation. 2023 Feb 21;147(8):e622. PMID: 36695182. Crossref, MedlineGoogle Scholar,

Overview

Patient Presentation

Treatment Goals

  • 1. Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e152S–e184S. Crossref, MedlineGoogle Scholar,
  • 2. Whitlock RP, Sun JC, Fremes SE, et al. Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141:e576S. Crossref, MedlineGoogle Scholar,
  • 3. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70(2):252–289. doi:10.1016/j.jacc.2017.03.011. Crossref, MedlineGoogle Scholar,

Disease State Management

  • 1. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e195S–e226S. Crossref, MedlineGoogle Scholar,
  • 2. Schünemann HJ, Cushman M, Burnett AE, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv. 2018;2(22):3198–3225. Crossref, MedlineGoogle Scholar,
  • 3. Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4(19):4693–4738. Crossref, MedlineGoogle Scholar,
  • 4. Stevens SM, Woller SC, Baumann Kreuziger L, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):2247–2259. doi:10.1016/j.chest.2021.07.056. Crossref, MedlineGoogle Scholar,
  • 5. Garcia DA, Baglin TP, Weitz JI, Samama M. Parenteral anticoagulants. Chest. 2012;141(2_suppl):e24S–e43S. Crossref, MedlineGoogle Scholar,
  • 6. Geerts WH1, Bergqvist D2, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008 Jun;133(6 Suppl):381S–453S. Crossref, MedlineGoogle Scholar,
  • 7. Arixtra package insert. Morgantown, WV: Mylan Institutional LLC; August 2020. Google Scholar,
  • 8. Ageno W, Gallus AS, Wittkowsky A, et al. Oral anticoagulant therapy. Chest. 2012;141(2_suppl):e44S–e88S. Crossref, MedlineGoogle Scholar,
  • 9. Madan S, Shah S, Dale P, et al. Use of novel oral anticoagulant agents in venous thromboembolism. Cardiovasc Diagn Ther. 2016 Dec; 6(6):570–581. Crossref, MedlineGoogle Scholar,
  • 10. Seliverstov I. Practical management approaches to anticoagulation non-compliance, health literacy, and limited English proficiency in the outpatient clinic setting. J Thromb Thrombolysis. 2011 Apr;31(3):321–325. Crossref, MedlineGoogle Scholar,
  • 11. Burnett AE, Mahan CE, Vazquez SR, et al. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis. 2016 Jan;41(1):206–232. Crossref, MedlineGoogle Scholar,

Medications

  • 1. Eliquis package insert. Princeton, NJ: Bristol-Myers Squibb; 2012 Dec. Google Scholar,
  • 2. Pradaxa package insert. Ridgefield, CT: Boehringer Ingelheim; 2015 Nov. Google Scholar,
  • 3. Savaysa package insert. Parsippany, NJ: Daiichi Sankyo; 2015 Jan. Google Scholar,
  • 4. Lovenox package insert. Bridgewater, NJ: Sanofi-aventis; 2013 Oct. Google Scholar,
  • 5. Garcia DA, Baglin TP, Weitz JI, Samama M. Parenteral Anticoagulants. Chest. 2012;141(2_suppl):e24S–e43S. Crossref, MedlineGoogle Scholar,
  • 6. Arixtra package insert. Morgantown, WV: Mylan Institutional LLC; August 2020. Google Scholar,
  • 7. Xarelto package insert. Titusville, NJ: Janssen Pharmaceuticals; 2017 Mar. Google Scholar,
  • 8. Coumadin package insert. Princeton, NJ: Bristol-Myers Squibb; 2016 Sept. Google Scholar,
  • 9. Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e152S–e184S. Crossref, MedlineGoogle Scholar,

Complementary and Integrative Health Approaches (CIHA)

  • 1. Belcaro G, Cesarone MR, Rohdewald P, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with Pycnogenol. Clin Appl Thromb Hemost. 2004;10:373–377. Crossref, MedlineGoogle Scholar,
  • 2. Glynn RJ, Ridker PM, Goldhaber SZ, et al. Effects of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism. Report from the Women’s Health Study. Circulation. 2007 Sep 10. CrossrefGoogle Scholar,
  • 3. Schastlivtsev I, Lobastov K, Barinov V, Kanzafarova I. Diosmin 600 in adjunction to rivaroxaban reduces the risk of post-thrombotic syndrome after femoropopliteal deep vein thrombosis: results of the RIDILOTT DVT study. Int Angiol. 2020 Oct;39(5):361–371. doi:10.23736/S0392–9590.20.04356-4. Epub 2020 Apr 29. PMID: 32348101. Crossref, MedlineGoogle Scholar,
  • 4. Tsai H-H, Lin H-W, Lu Y-H, Chen Y-L, Mahady GB (2013) A Review of Potential Harmful Interactions between Anticoagulant/Antiplatelet Agents and Chinese Herbal Medicines. PLoS ONE. 2013;8(5):e64255. Crossref, MedlineGoogle Scholar,
  • 5. Nutescu E, Chuatrisorn I, Hellenbart E. Drug and dietary interactions of warfarin and novel oral anticoagulants: an update. J Thromb Thrombolysis. 2011;31(3):326–343. Crossref, MedlineGoogle Scholar,

Monitoring and Follow-Up

Practical Clinical Management Tips

  • 1. Burnett AE, Mahan CE, Vazquez SR, et al. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis. 2016 Jan;41(1):206–232. Crossref, MedlineGoogle Scholar,
  • 2. Kovacs RJ, Flaker GC, Saxonhouse SJ, et al. Practical management of anticoagulation in patient with atrial fibrillation. J Am Coll Cardiol. 2015 Apr 7;65(13):1340–1360. Crossref, MedlineGoogle Scholar,
  • 3. Wang Y, Bajorek B. New oral anticoagulants in practice: pharmacological and practical considerations. Am J Cardiovasc Drugs. 2014 Jun;14(3):175–189. Crossref, MedlineGoogle Scholar,
  • 4. Abo-Salem E, Becker R. Transitioning to and from the novel oral anticoagulants: a management strategy for clinicians. J Thromb Thrombolysis. 2014 Apr;37(3):372–379. Crossref, MedlineGoogle Scholar,
  • 5. Ageno W, Gallus AS, Wittkowsky A, et al. Oral anticoagulant therapy. Chest. 2012;141(2 suppl):e44S–e88S. Crossref, MedlineGoogle Scholar,

Pharmacogenomics Implications

Cultural Sensitivities and Health Disparities

  • 1. Beckman MG, Hooper WC, Critchley SE, et al. Venous thromboembolism: a public health concern. Am J Prev Med. 2010 Apr;38(4 Suppl):S495–501. Crossref, MedlineGoogle Scholar,
  • 2. White RH, Keenan CR. Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res. 2009;123 Suppl 4:S11–7. doi:10.1016/S0049-3848(09)70136-7. Crossref, MedlineGoogle Scholar,
  • 3. Lau BD, Haider AH, Streiff MB, et al. Eliminating health care disparities with mandatory clinical decision support: the venous thromboembolism (VTE) example. Med Care. 2015 Jan;53(1):18–24. Crossref, MedlineGoogle Scholar,
  • 4. Sullivan LT, Jackson LR, Thomas KL. Review of venous thromboembolism and race: the generalizability of treatment guidelines for high-risk populations. J Thromb Thrombolysis. 2016 Aug;42(2):167–171. Crossref, MedlineGoogle Scholar,
  • 5. Akinboboye O. Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity? Journal of Multidisciplinary Healthcare. 2015;8:217–228. Crossref, MedlineGoogle Scholar,
  • 6. Garwood CL, Clemente JL, Ibe GN, et al. Warfarin maintenance dose in older patients: higher average dose and wider dose frequency distribution in patients of African ancestry than those of European ancestry. Blood Cells Mol Dis. 2010;45(1):93–97. Crossref, MedlineGoogle Scholar,
  • 7. Wilson FL, Racine E, Tekieli V, et al. Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy. J Clin Nurs. 2003;12(2):275–282. Crossref, MedlineGoogle Scholar,
  • 8. Chiang CE, Wang KL, Lip GY. Stroke prevention in atrial fibrillation: an Asian perspective. Thromb Haemost. 2014;111:789–797. Crossref, MedlineGoogle Scholar,
  • 9. Eliquis package insert. Princeton, NJ: Bristol-Myers Squibb; 2012 Dec. Google Scholar,
  • 10. Apostolakis S, Sullivan RM, Olshansky B, et al. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT(2)R(2) score. Chest. 2013;144(5):1555–1563. Crossref, MedlineGoogle Scholar,
  • 11. Cruess DG, Localio AR, Platt AB, et al. Patient attitudinal and behavioral factors associated with warfarin non-adherence at outpatient anticoagulation clinics. Int J Behav Med. 2010;17(1):33–42. Crossref, MedlineGoogle Scholar,
  • 12. Platt AB, Localio AR, Brensinger CM, et al. Risk factors for nonadherence to warfarin: results from the IN-RANGE study. Pharmacoepidemiol Drug Saf. 2008 Sep;17(9):853–860. Crossref, MedlineGoogle Scholar,
  • 13. Seliverstov I. Practical management approaches to anticoagulation non-compliance, health literacy, and limited English proficiency in the outpatient clinic setting. J Thromb Thrombolysis. 2011 Apr;31(3):321–325. Crossref, MedlineGoogle Scholar,
  • 14. Misky GJ1, Carlson T, Thompson E, et al. Implementation of an acute venous thromboembolism clinical pathway reduces healthcare utilization and mitigates health disparities. J Hosp Med. 2014 Jul;9(7):430–435. Crossref, MedlineGoogle Scholar,

Special Populations

  • 1. Monagle P, Chan AK, Goldenberg NA, et al. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e737S–e801S. Crossref, MedlineGoogle Scholar,
  • 2. Malec L, Young G. Treatment of venous thromboembolism in pediatric patients. Front Pediar. 2017;5:26. MedlineGoogle Scholar,
  • 3. Monagle P, Cuello CA, Augustine C, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018;2(22):3292–3316. Crossref, MedlineGoogle Scholar,
  • 4. Bates SM, Greer IA, Middeldorp S, et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e691S–e736S. Crossref, MedlineGoogle Scholar,
  • 5.
    The 2019 American Geriatrics Society Beers Criteria® Update Expert Panel
    . American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–694. doi:10.1111/jgs.15767. Crossref, MedlineGoogle Scholar,
  • 6. Stevens SM, Woller SC, Baumann Kreuziger L, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):2247–2259. doi:10.1016/j.chest.2021.07.056. Crossref, MedlineGoogle Scholar,
  • 7. Lyman GH, Carrier M, Ay C, et al. American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv. 2021;5(4):927–974. Crossref, MedlineGoogle Scholar,
  • 8. Zuily S, Cohen H, Isenberg D, et al. Use of direct oral anticoagulants in patients with thrombotic antiphospholipid syndrome: guidance from the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. J Thromb Haemost. 2020;18(9):2126–2137. doi:10.1111/jth.14935. Crossref, MedlineGoogle Scholar,
  • 9. Martin KA, Beyer-Westendorf J, Davidson BL, Huisman MV, Sandset PM, Moll S. Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation. J Thromb Haemost. 2021;19(8):1874–1882. doi:10.1111/jth.15358. Crossref, MedlineGoogle Scholar,
  • 10.
    COVID-19 Treatment Guidelines Panel
    . Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed December 5, 2022. Google Scholar,

Interprofessional Collaborative Practice

  • 1. Council on Credentialing in Pharmacy, Albanese NP, Rouse MJ. Scope of contemporary pharmacy practice: roles, responsibilities, and functions of pharmacists and pharmacy technicians. J Am Pharm Assoc. 2010;50(2):e25–e69. Google Scholar,

Session Activity

Recently Viewed
Recently Searched

No search history