RESUMO
Dabigatran is a novel direct thrombin inhibitor that has proven effective in the prevention of vascular events in patients with nonvalvular atrial fibrillation. Not much is known about the clearance capability with extracorporeal techniques of dabigatran. This review showcases the pharmacokinetics and a perusal of the current literature regarding cases that involved the clearance of the drug in patients with normal renal function and end-stage renal disease. Renal replacement therapy represents a therapeutic option to eliminate dabigatran and decreased the risk of bleeding in patients undergoing emergent surgical procedures on dabigatran.
Assuntos
Antitrombinas/farmacocinética , Fibrilação Atrial/tratamento farmacológico , Dabigatrana/farmacocinética , Diálise Renal , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Taxa de Depuração MetabólicaRESUMO
AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case.This report examines the story of a 73-year-old man who sought evaluation for 1 month of shortness of breath, bilateral lower-extremity edema, and weight gain of 14 kg. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.