Abstract
ORAL ANTICOAGULANTS: CHALLENGES IN PAKISTAN. DO WE HAVE A SOLUTION?
Highlights
The common public health problem in thromboembolic disorders (TED) are venous thromboembolism (VTE) and stroke caused by Atrial Fibrillation (AF).[1]
The problems encountered with Vit K antagonist (VKAs) relate to dietary patterns in the region resulting in drug interaction, over usage of non-steroidal antiinflammatory drugs (NSAIDs) and most important the lack of lab facilities to monitor international normalized ratio (INR), and the lack of awareness of target INR levels by physicians & patients
The main challenge for stroke prevention is in pregnant women with AF who have either mechanical valve or severe valvular disease (Mitral Valve disease) in adjusting VKAs dose
Summary
The common public health problem in thromboembolic disorders (TED) are venous thromboembolism (VTE) and stroke caused by Atrial Fibrillation (AF).[1] The main stay of treatment among oral anticoagulants are Vit K antagonist (VKAs) like warfarin and acenocoumarin, warfarin has been the most commonly used drug in Pakistan. Non Vitamin K dependent oral anticoagulants (NOACs) such as dabigatrin, rivaroxaban and apixaban have come in to use.[2] Till VKAs are most extensively used in developing countries like India3 & Pakistan because of their effects can be reversed, and they are safe in impaired renal function besides being cost effective.
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