NATS 1540 Chapter Notes - Chapter 3.0: Atrial Fibrillation, Sinus Rhythm, Calcium Channel Blocker
31 May 2020
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Justify your recommendations (interventions) considering efficacy, safety, convenience & cost. The first task that should be done when assessing helen is her risk of stroke. Given her age and current medical conditions, she receives a chads2 score of 3, placing her in the high risk group, and is eligible for oral anticoagulant (oac) therapy. She was already on dabigatran, which is an appropriate oac for this indication, however, she was experiencing an adverse event from it (dyspepsia). Because of this, the decision was made to switch her to apixaban. Apixaban was shown to be more effective than warfarin (and, by extension, rivaroxaban), so it is the ideal oac for helen. Beta blockers (bb) and calcium channel blockers (ccb) are appropriate options as antiarrhythmics for patients with atrial fibrillation, who have no history of heart disease. The patient was already on bisoprolol, but was experiencing exercise intolerance.
