OpenDoorDocs.org

Urban Ministries of Wake County

Open Door Clinic

Support & Tools for Anti-Coagulant Management

Updated:
May, 2011
Gary Greenberg, MD
(email )

Presentation (given 5/12/11

Spreadsheets/ Tools

Documents

References / Links

Presentation (5/12/11)

    Powerpoint content can be downloaded here. Because of images (of the spreadsheets) it's grown to almost 2 Meg

 

 

Spreadsheets / Tools:

    Here's the Open Door Clinic Anticoagulation Tracking Form, as modified 5/8/11

    Here's the Open Door Patient Worksheet for anticoagulation monitoring, as of 5/9/11

    A very useful calculation tool allows you to invent and compare 2 warfarin regimens with different proportions of 2 doses in each of 2 weeks. For changing pill-sizes, it's very comforting to be certain that the weekly dose is as you hoped it would be.

 

 

Documents:

    Here is a modified version of the document  (Word format) produced by the Medical Mutual of NC insurance company. I believe the document is better with some explanation of cliinical logistics and contact information. It also discusses and presents my idiosyncratic use of Vitamin K as a daily supplement.

 

 

References / Links:

  • Coumadin Rap (I played this at the start of our talk, and heard it during the Annals podcast linked below)
  • Calculator for Atrial Fib risk using either CHADS2 or CHA2DS2-VASc and even performs the HAS-BLED a risk predictor for hemorrhage
  • Supportive studies for supplementing Vitamin K
    • Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin published Blood, 2007 109:2419-2423 online abstract
    • Vitamin K1 supplementation to improve the stability of anticoagulation therapy with vitamin K antagonists: a dose-finding study published Haematologica, 2011 96: 583-589 Online abstract
  • Most recent review of new drugs, including podcast April 5, 2011 and published "Update in Hematology and Oncology" Schilsky R, Crowther M Ann Intern Med April 5, 2011 154:487-494
  • Drug guidance
    • NeedyMeds.org has pretty reliable information on corporate medication assistance programs
    • DailyMeds is run by the National Library of Medicine (the best of all sources, bar-none) and includes the full-text of the package insert and other details
  • Therapy and clinical decisions guidelines