Pradaxa - page 2

Has anyone heard of the drug Pradaxa?? It's a new blood thinner medication that is supposedly "better than coumadin." Haven't seen it in our hospital yet, but i'm sure i will in a cardiac unit if it... Read More

  1. Visit  Anna Flaxis profile page
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    I just recently heard about it, and haven't seen any patients on it yet.
  2. Visit  NRSKarenRN profile page
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  3. Visit  TeleMeMore profile page
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    Quote from DroogieRN
    I'm on a Tele floor and suddenly I am seeing it constantly in my AFib patients.

    Same here.
  4. Visit  al586 profile page
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    Pradaxa is used selectively in our SNF, since it cannot be crushed or even taken out its capsule. (The potency can increase significantly if taken out of its capsule.) Therefore, we can only use it with patients that are able to swallow the capsule whole. Here's a link to a "Do Not Crush" List..you'll find Pradaxa there.

    http://www.ismp.org/Tools/default.asp
  5. Visit  gettingbsn2msn profile page
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    I met the pradaxa rep in our area recently. This is per the rep. They are expecting pradaxa to be a blockbuster drug. It is already showing signs of it. The cost does not appear to be a problem in some areas. The patients are willing to pay it if one factors the cost of gas to go get bloodwork. With gas prices bumping up against 4.00 the rural patients cannot drive to get their bloodwork done. Also some insurance companies (again per the rep) are willing to pay it to avoid the expense of lab costs. It will be interesting to see how this plays out.
  6. Visit  libbyliberal profile page
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    Pradaxa can not be reversed with FFP or anything. If your pt has a head bleed or GIB you can't take them to surgery. No thanks.
  7. Visit  psu_213 profile page
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    Quote from gettingbsn2msn
    With gas prices bumping up against 4.00 the rural patients cannot drive to get their bloodwork done.
    I had honestly never thought about this. Did you come up with this or hear it from the drug rep? Now, if the drug rep said it, it is to gain support for his drug. Either way, this is still a true barrier to care.
  8. Visit  psu_213 profile page
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    Quote from lvICU
    If the bleeding is acute, factor VIIa could be used.
    Is that indeed true? One of our ER doctors (a very good, smart doctor might I add) was talking with a resident about Pradaxa. He expressed concerns that there was no reversal agent...he made it seem like there was absolutely no way to reverse therapeutic effects. If thats the case, then supportive care (IVF, RBCs, etc) are not going to cut it on a head bleed or someone who needs surgery now.
    Last edit by psu_213 on Jan 4, '12 : Reason: clarification
    VickyRN likes this.
  9. Visit  psu_213 profile page
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    Quote from SC_RNDude
    I've seen it with maybe 6-8 pts in the last few months, all with Afib.
    If I am not mistaken, right now it is only approved for preventing clots caused by A fib...not yet for other clotting disorders.
    Last edit by psu_213 on Jan 4, '12 : Reason: .
  10. Visit  Sdh0725 profile page
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    I had a patient transfered to me from the ICU who had previously (before hospitalization) been on it. One of the benefits is it doesn't require monthly lab work, but the bleeding risk is very high and dangerous. The patient lost a lot of blood from a pyluric ulcer and it seemed that the pradaxa was to blame for him almost not making it. He was very happy to be off the med.
    fiveofpeep likes this.
  11. Visit  EMSnut45 profile page
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    My ICU has had 6 SEVERE GI bleeders due to this drug in the past few months. They bleed for days with nothing to reverse the medication effects. We just pour in blood as they pour it back out from usually multiple areas. Of course they are not surgical candidates, and IR is risky as well. Our staff is not impressed at all with this drug.
    VickyRN and fiveofpeep like this.
  12. Visit  msjellybean profile page
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    I just started on a neuro floor a few months ago. One of my very first patients was a 53yo female that had a massive hemorrhagic stroke, after being on Pradaxa. Floated to another floor a couple weeks ago & had a woman that ended up with a GI bleed as a result of it. Haven't had any other patients on it.

    It scares me that there's no easy antidote.
    VickyRN likes this.
  13. Visit  Hygiene Queen profile page
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    Quote from al586
    Pradaxa is used selectively in our SNF, since it cannot be crushed or even taken out its capsule. (The potency can increase significantly if taken out of its capsule.) Therefore, we can only use it with patients that are able to swallow the capsule whole. Here's a link to a "Do Not Crush" List..you'll find Pradaxa there.

    Medication Safety Tools and Resources
    Yeah, that.
    I caught myself before I emptied the contents into applesauce for a difficult pt.
    Glad I checked first... especially when I discovered it had no antidote either

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