For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Stopping anticoagulants before medical procedures: No easy ‘recipe’
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In print
Heartbeat
Stopping anticoagulants before medical procedures: No easy ‘recipe’
Wednesday 15 February 2023, 12:30 AM

[ECG supplied]
Consultant cardiologist Chris Ellis examines the details of withholding anticoagulant medication prior to an invasive procedure, where the risk of bleeding versus thrombosis must be carefully balanced
Key points, Careful judgement is required to determine how long to withhold anticoagulants for perioperative management of patients in atrial fibrillation.
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Kia ora and welcome to New Zealand Doctor Rata Aotearoa
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References
BPACnz and Pharmac. Guidelines for testing and perioperative management of dabigatran and rivaroxaban: for possible use in local management protocols. 2018. bpac.org.nz/2018/bleeding-guidelines.aspx