dabigatran- from neurosurgical viewpoint-what a neurosurgeon should know...

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subhayanmandal

what a Neurosurgeon should know about dabigatran

Health & Medicine

subhayanmandal@gmail.com
AS THE OPINIONS AND MEDICINES
FAIL
LIVES TASTE THE
SUFFERINGS OF HAIL
IT’S NEUROWISH, KNOWLEDGE AND
SURGEON’S SCALPEL
BRING THE
HAPPINESS UNVEIL

Dabigatran in Neurosurgeons’ knowledge cognition level
EXECUTIVENESS IN TERMS OF PHARMACOKINETICS & PHARMACODYNAMICS
ELEGANCY OF USAGE
SIDE EFFECTS IN NEUROSURGICAL PERSPECTIVE
FUTURE DIRECTIONS …OFF THE LABEL USAGE
OPERATE NICELY A PATIENT WITH THE MOLECULE…….THE HOLISTICS
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ELEGANCY OF DOSING………………………..
subhayanmandal@gmail.com

MECHANISTIC PLAUSIBILITY OF USAGE EVEN IN
HAEMOPHILLIAC
subhayanmandal@gmail.com
Warfarin
(Coumadin®)
Dabigatran
(Pradaxa®)
Rivaroxaba
(Xarelto®)
Apixaban
(Eliquis®)
Edoxaban
(Savaysa®)
Drug Class
Anticoagulant
(vitamin K
antagonist)
Anticoagulant
(direct thrombin
inhibitor)
Anticoagulant
(factor Xa inhibitor)
Anticoagulant
(factor Xa inhibitor)
Anticoagulant
(factor Xa inhibitor)
Mechanism
of Action
Depletes vitamin K
inhibiting factors II,
VII, IX, X
Reversible direct
thrombin inhibitor
(PRODRUG)
Selective inhibition
of factor Xa
Selective inhibition
of factor Xa
Selective inhibition
of factor Xa

Supremacy albeit less side effects..
Report of meta-analysis…………
o Source of data from
I. Medline Ovid (1946 to Oct.2015)
II. Embrace Ovid (1980-Oct 2015 )
III. Cochrane Central Register of Control Trial (CENTRAL, Issue 92015 )
o Oral anticoagulants are more effective than anti-platelelet agents in
reducing ischaemic stroke
o Compared to warfarin dabigatran reduces risk of al strokes
o Some novel oral anticoagulants – Dabigatran, Apixaban, Edoxaban in
compare to warfarin have less chances of major bleeding
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Can be continued in ischaemic stoke with recent
micro-haemorrhagic conversion?????
Yes
Yes
Yes
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Use of Dabigatran in peri-operative period….
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Concommitant rtPA with Reversal agent???
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Dabigatran …off label usage
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Dabigatran and vascular dementia
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Dabigatran and MS
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There are BUTS…….
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Takehome message
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