Pradaxa - page 3

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 claims to be as good as it... Read More

  1. 1
    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.

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  2. 0
    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: .
  3. 1
    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.
  4. 2
    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.
  5. 1
    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.
  6. 0
    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"'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
  7. 1
    Had this resident on it. Seems great, however, unlike coumadin, PRADAXA has no antidote and if you suspect hemmorhagic issues, the patient MUST be sent out immediately. The risk of increased GI bleeding accompany this drug at a higher rate than coumadin. For those patients that luck out I suppose it is wonderful.
    Forever Sunshine likes this.
  8. 1
    Another thing to remember is that patients should not have pradaxa for 2days prior to any invasive procedure (at least that's what's recommended). There is no lab to test for pradaxa - PT/INR won't do it.
    VickyRN likes this.
  9. 0
    Coumadin is the drug of choice at my hospital, but I have seen a few patients on Pradaxa, mainly those who have already been on it prior to being admitted.
  10. 0
    My Dad has received 8 units of blood since Saturday. Today is monday. Rectal bleeding that they cannot find the origins of (after colonoscopy, Endoscopy, Scan..etc) so it has been deduced to his Defib Dr switching to Pradaxa just under 2wks ago. He has COPD, CHF, Defib, Sleep apnea....78yrs old.

    BP at admisson was 70's/30's, A-Fib, H/H 6.4, K 6.6 (cocktail given), acute renal failure and a Catheter was inserted in the event he will need Dialysis.

    His Nephrologist explained that he was very very sick and that he was concerned. I never heard a Dr speak like this.

    As of today he is responding well from the treatments/interventions. He will move from ICU to a regular floor tomorrow. bleeding has slowed, but not stopped.

    every Dr has pointed to Pradaxa as being the culprit thus far.

    if all goes well, they will send him home with Coumadin.

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