Just writing for some advice. A friend's mother is in the hospital. She is 93 years old and miraculously recovering from a vicious attack of pneumonia (her 2nd case this year). While there, it was discovered that she is having transient episodes of atrial fib (I witnessed one episode on the monitor while I was visiting - lasted about 10 seconds before going back into NSR). Well, they want to put her on Coumadin, of course. But she is extremely frail, tiny, and weighs at the most 90 pounds. She also is very sensitive to medications, and I am concerned that any dose of Coumadin, no matter how small, is going to cause her to have a nasty GI bleed or worse. Is there any other prophylactic anticoagulant/ antiplatelet agent that she could be on for her transient episodes of atrial fib? I have noted some doctors putting frail elderly patients on EC-ASA instead. What do you think? Thank you for any insight you can offer me
Apr 2, '05
The thing that is nice about coumadin is that it is tested very regularily and monitored closely (that is if the patient does their follow up!). In my facility (assisted living) people are watched very highly for this, tested regularily, and their orders change dependant on their PT/INR very well! I find that this type of monitoring is excellent, and not something done with some other meds!
I have frail folks over 100 that have coumadin, but you have to outweight the use for that and the condition they are experiencing. We can fix a bleed normally..but a fib can turn ugly fast, and then it is much more invasive to fix! So MD's have to look at the pro's and con's and order carefully!
But like I said, my residents on coumadin are watched like hawks..means lots of blood labs, but it is so wonderful to have them monitored so very carefully (we have a lab team come in and do this, I hear private home folks can too and covered by insurance!).
Amioderone and Lovenox are VERY VERY expensive..outragously so!!!!!!
Last edit by Antikigirl on Apr 2, '05