The Annals of pharmacotherapy
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Despite evidence that antithrombotics are effective in reducing the risk of stroke in atrial fibrillation (AF), they remain underused. ⋯ The educational program described here led to a significant increase in the prescribing of warfarin for stroke prevention in patients with AF.
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There are limited data on dosing of enoxaparin in patients with renal disease due to the routine exclusion of this population in clinical trials. To account for the potentially delayed drug elimination in these patients, we developed guidelines for adjusting enoxaparin dosing based on anti-Xa monitoring. ⋯ Although the relationship between anti-Xa activity, efficacy, and adverse effects has not been definitively established, anti-Xa levels can assist with dosing of enoxaparin in renally impaired patients. Our hospital guidelines are effective in adjusting dosing to reach target anti-Xa levels.