Question

1.compare warfarin and factor Xa small molecule inhibitor

2.Compare Heparin and tPA treatments for myocardial infarction

3. Clinical problems associated with anticoagulants, anti platelet-aggregants, and fibrinolysis stimulators

Answer 1

1. Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with Atrial Fibrillation.

Factor Xa inhibitors also reduced the number of IntraCranial Haemorrhages, all-cause deaths and major bleedings compared with warfarin, although the evidence for a reduction in the latter is less robust.

2.

Heparin	tPA Treatment
Heparin therapy is given as an adjunct to thrombolytic treatment for patients with acute myocardial infarction is to prevent rethrombosis after successful thrombolysis	Thrombolytic therapy is indicated in patients with evidence of ST-segment elevation MI (STEMI) or presumably new left bundle-branch block (LBBB) presenting within 12 hours of the onset of symptoms if there are no contraindications to fibrinolysis. Alteplase (tPA) is a powerful thrombolytic agent used in the lysis of acute thromboembolism
Heparin therapy consists of a bolus dose of 5,000-10,000 units, followed by a continuous infusion to maintain the activated partial thromboplastin time at 1.5-2.5 times the control value, and should be continued for 5-10 days in most patients.	Alteplase can be administered in an accelerated infusion (1.5 hr) using 50-mg and 100-mg vials reconstituted with sterile water to 1 mg/mL. Accelerated infusion of alteplase for AMI consists of a 15-mg IV bolus followed by 0.75 mg/kg (up to 50 mg) IV over 30 minutes and then 0.5 mg/kg (up to 35 mg) IV over 60 minutes. The maximum total dose is 100 mg for patients weighing more than 67 kg. This is the most common alteplase infusion parameter used for AMI

3. Bleeding will not stop easily while taking anticoagulants, anti platelet-aggregants and firbrinolysis stimulators.

Patients at high risk of bleeding problems if they have uncontrolled Blood Pressure, history of Stroke, Stomach Ulcers, Kidney problems, Cancer, Alcoholism, Liver disease.

It causes Nausea, Stomach upset, Diarrhea, Blood in the urine and stool, Nosebleeds, Heavy bleeding from cuts, unusual heavy menstrual bleeding,dizziness, shortness of Breath etc.