Wednesday, August 20, 2014
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

New medications prevent harmful blood clots

By
From page B10 | January 26, 2013 |

Among the fifteen million patients discharged from hospitals in the United States annually, an estimated 51 percent are at risk of developing blood clots, called “thromboses,” or of spread of these clots to vital organs, which we call “embolism.”

Prevention of blood clots is an important issue. We are particularly concerned about this problem in persons with underlying medical problems that predispose to poor circulation, such as swelling of the legs, diabetes, or chronically irregular heart beats.

Typically, we prescribe blood thinners in the wake of a catastrophic event involving a blood clot. Examples include a blood clot in the legs. This may occur out of the blue, as an “idiopathic” or unexplained phenomenon.

Other causes may include the use of birth control pills, prolonged immobility on a long airplane flight, or impaired circulation due to prior injuries to the legs. There are also less common conditions that predispose an individual to blood clot formation, including inherited deficiencies or mutations in blood coagulation proteins.

Hematologists are experts at sorting out these conditions, as internal medicine specialists with expertise in diagnosing and treating blood disorders. Systemic lupus erthematosus, an auto-immune disease within my own field of rheumatology, can cause the blood to be excessively prone to clotting. When you think of it, the blood is a marvelous body tissue, capable of clotting when we have an accident and get cut, but also capable of coursing unimpeded through our arteries and veins from day-to-day. It is no wonder that this marvelous balance is occasionally perturbed. In fact, it is amazing that our blood works as well as it does, most of the time.

The most feared complication of a lower extremity blood clot is the possibility of an embolus, or broken off clot, passing through the blood to the heart, brain or lungs. The latter condition, called a “pulmonary embolism,” is potentially life-threatening and often difficult to diagnose, causing the sudden onset of shortness of breath, chest pain, and even sudden death. Severe blood clots may necessitate life-long blood-thinning, or “anti-coagulation” therapy. Traditionally, this involved two medications, heparin and coumadin. Heparin has a rapid effect, and used to be given intravenously in hospitals.

About thirty years ago, researchers developed a more convenient type of heparin, called “low molecular weight,” which is injectable under the skin. As heparin thins the blood acutely, a longer acting medication taken orally, called coumadin, is typically prescribed. The problem with coumadin, however, is that patients on this medication require constant rechecking of blood tests, and constant adjustment of the medication. For example, dietary intake of high levels of vegetables can lower the effect of the medication, necessitating a higher dose. Conversely, some medications can alter metabolism of the drug, necessitating that coumadin doses be lowered. I once ran a clinic entirely devoted to adjusting coumadin levels on patients in a large institutional setting. That is how cumbersome coumadin therapy may be. New drugs, however, are on the horizon, if not already available.

Pradaxa (dabigatran etexilate) and Xarelto (rivaroxaban) are approved alternatives to coumadin. Last month, the Food and Drug Administration also announced approval of Eliquis (apixaban) as another anticlotting drug. Pharmaceutical manufacturers are jockeying to develop newer agents that offer greater ease of administration, with comparable efficacy to older agents.

Elderly patients with irregular heart rhythms, such as “atrial fibrillation,” represent a common therapeutic challenge. An irregular heart rhythm may lead to blood clot formation, with the potential for a secondary stroke developing. Staying active and well hydrated is a good idea for most patients. Contracting leg muscles, for example, improves circulation to and from the legs. For specific recommendations, see your physician.

Scott Anderson, M.D., Ph.D. (stamdphd@comcast.net) is Clinical Professor of Medicine, Division of Rheumatology, UC Davis. This column is informational, and does not constitute medical advice.

Scott Anderson

LEAVE A COMMENT

Discussion | 1 comment

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

  • CD BrooksApril 30, 2013 - 6:59 am

    Abigail, they are both very much like Conservatives. For example, Boehner would be an aneurysm where he sneaks in with very little evidence, inflates, gets weak and explodes, so without immediate care you bleed out. McConnell would be the blood clot where he rolls around through your veins and if allowed to continue, goes to your heart or brain and kills you. But no worries, the “physicians” among you will replace the threats in 2014. Okay?

    Reply | Report abusive comment
.

Solano News

 
Memorial flight honors beloved Gordon Valley man

By Ian Thompson | From Page: A1, 2 Comments | Gallery

 
Vacaville school board candidates sound off during forum

By Susan Winlow | From Page: A1 | Gallery

Recology goes pink to trash cancer

By Glen Faison | From Page: A2 | Gallery

 
Caltrans advises Highway 12 delays likely

By Barry Eberling | From Page: A3, 3 Comments

 
Curtola park-and-ride bill goes to governor

By Barry Eberling | From Page: A3

 
City reaches milestone for train station project

By Barry Eberling | From Page: A3, 16 Comments | Gallery

 
Man convicted of failing to register as sex offender

By Ryan McCarthy | From Page: A5, 15 Comments | Gallery

 
DUI checkpoint nets arrests in Vacaville

By Ryan McCarthy | From Page: A5, 7 Comments

 
Library’s teen board to meet next week

By Glen Faison | From Page: A5

South Solano Dems schedule candidates meet, greet

By Glen Faison | From Page: A5

 
 
Geiger sworn in as Fairfield planning commissioner

By Ryan McCarthy | From Page: A6

 
Faith in Action puts out call for volunteers

By Glen Faison | From Page: A6

 
Love, a legend, come to theaters

By Amy Maginnis-Honey | From Page: A7

Fairfield police log: Aug. 18, 2014

By Susan Hiland | From Page: A12

 
Suisun City police log: Aug. 16, 2014

By Glen Faison | From Page: A12

Suisun City police log: Aug. 17, 2014

By Glen Faison | From Page: A12

 
Fairfield police log: Aug. 16, 2014

By Glen Faison | From Page: A12

Fairfield police log: Aug. 17, 2014

By Glen Faison | From Page: A12

 
Suisun City police log: Aug. 18, 2014

By Susan Hiland | From Page: A12

.

US / World

As protests rage, Obama struggles to find his role

By The Associated Press | From Page: A1 | Gallery

 
Ferguson pledges outreach efforts after shooting

By The Associated Press | From Page: A1

How can authorities restore order in Ferguson?

By The Associated Press | From Page: A1, 21 Comments | Gallery

 
Holder brings his civil rights push to Ferguson

By The Associated Press | From Page: A1, 3 Comments

Strong DOJ response to Ferguson seeks truth, calm

By The Associated Press | From Page: A1

 
Prison company pays $8 million in back wages

By The Associated Press | From Page: A6

Some evacuees of Yosemite-area fire can go home

By The Associated Press | From Page: A6 | Gallery

 
Officials say Lake Tahoe imperiled by wildfires

By The Associated Press | From Page: A8

Committee approves higher pension calculations

By The Associated Press | From Page: A8

 
Veteran rock climber killed in fall in Yosemite

By The Associated Press | From Page: A8 | Gallery

Texas Gov. Perry booked on abuse of power charges

By The Associated Press | From Page: A9, 3 Comments

 
US officials: Video shows American’s beheading

By The Associated Press | From Page: A9

NY took quick precautions after in-custody death

By The Associated Press | From Page: A10 | Gallery

 
AP Exclusive: US changing no-fly list rules

By The Associated Press | From Page: A10

Tens of thousands march on Pakistan’s parliament

By The Associated Press | From Page: A13 | Gallery

 
.

Opinion

No getting away from corruption in state government

By Thomas Elias | From Page: A11

 
Editorial cartoons for Aug. 20, 2014

By Daily Republic Syndicated Content | From Page: A11

 
Serve and protect? Certainly not

By Letter to the Editor | From Page: A11, 23 Comments

 
Question of the week: Does school start too soon?

By Daily Republic | From Page: A11

Government trying to steal rights

By Letter to the Editor | From Page: A11, 20 Comments

 
.

Living

Community Calendar: Aug. 20, 2014

By Susan Hiland | From Page: A2

 
Today in History: Aug. 20, 2014

By The Associated Press | From Page: A2

Horoscopes: Aug. 20, 2014

By Holiday Mathis | From Page: B5

 
Our daughter says she hates her mother and refuses to talk to us

By Kathy Mitchell and Marcy Sugar | From Page: B5

10 Things: 10 fresh ways to dress corn on the cob

By The Associated Press | From Page: B6

 
Think beyond the slice with refreshing watermelon

By J.M. Hirsch | From Page: B6

 
.

Entertainment

Dwayne ‘The Rock’ Johnson set for DC Comics film

By The Associated Press | From Page: A7, 1 Comment

 
Don Pardo, iconic TV announcer, dies at 96

By The Associated Press | From Page: A7

Wife to bury Kasem in Norway, cites heritage

By The Associated Press | From Page: A7, 1 Comment

 
TVGrid

By Daily Republic Syndicated Content | From Page: B7

.

Sports

49ers sign defensive lineman Dorsey to extension

By The Associated Press | From Page: B1

 
49ers’ Dawson eager to get back out kicking after misses

By The Associated Press | From Page: B1 | Gallery

 
Rancho Solano women’s team vying for spot in nationals

By Paul Farmer | From Page: B1 | Gallery

Joe Gibbs Racing hires Carl Edwards and Daniel Suarez

By The Associated Press | From Page: B2

 
Philadelphia’s Mo’ne Davis knows hoops, too

By The Associated Press | From Page: B2

Veteran NBA ref Bavetta retires after 39 years

By The Associated Press | From Page: B2

 
Raiders still waiting for Hayden to get healthy

By The Associated Press | From Page: B2 | Gallery

As Durant steps back, US team is moving forward

By The Associated Press | From Page: B2 | Gallery

 
Kluwe, Vikings reach settlement to avert lawsuit

By The Associated Press | From Page: B2

Islanders announce sale of minority stake of club

By The Associated Press | From Page: B2

 
Ohio State: Injured QB Miller done for the season

By The Associated Press | From Page: B2

Past US Open champs Djokovic, Federer seeded 1-2 in U.S. Open

By The Associated Press | From Page: B2

 
.

Business

Ballmer steps down from Microsoft board

By The Associated Press | From Page: B7

 
Competition heats up for Tesla’s gigafactory

By Mcclatchy-Tribune News Service | From Page: B7

Consumer prices edge up 0.1 percent in July

By The Associated Press | From Page: B8

 
Stocks rise as US home construction rebounds

By The Associated Press | From Page: B8

US home construction jumps 15.7 percent in July

By The Associated Press | From Page: B8, 1 Comment

 
Peanut, almond butter recalled for salmonella risk

By The Associated Press | From Page: B8, 1 Comment

McDonald’s to sell packaged coffee nationally

By The Associated Press | From Page: B8

 
.

Obituaries

Richard Ray Jr.

By Nancy Green | From Page: A4

 
Horace James Sam

By Nancy Green | From Page: A4

Joseph ‘Joey’ Kenneth Meyers

By Nancy Green | From Page: A4

 
Defrances Jean Freeman-Jefferson

By Susan Hiland | From Page: A4

Eddie Lee Staten

By Nancy Green | From Page: A4

 
June Canaris-Heath

By Brad Stanhope | From Page: A4

.

Comics

Beetle Bailey

By Daily Republic Syndicated Content | From Page: B4

 
For Better or Worse

By Daily Republic Syndicated Content | From Page: B4

Baby Blues

By Daily Republic Syndicated Content | From Page: B4

 
B.C.

By Daily Republic Syndicated Content | From Page: B4

Pickles

By Daily Republic Syndicated Content | From Page: B4

 
Baldo

By Daily Republic Syndicated Content | From Page: B4

Rose is Rose

By Daily Republic Syndicated Content | From Page: B4

 
Garfield

By Daily Republic Syndicated Content | From Page: B4

Wizard of Id

By Daily Republic Syndicated Content | From Page: B4

 
Get Fuzzy

By Daily Republic Syndicated Content | From Page: B4

Zits

By Daily Republic Syndicated Content | From Page: B4

 
Dilbert

By Daily Republic Syndicated Content | From Page: B4

Blondie

By Daily Republic Syndicated Content | From Page: B4

 
Sally Forth

By Daily Republic Syndicated Content | From Page: B4

Frank and Ernest

By Daily Republic Syndicated Content | From Page: B4

 
Peanuts

By Daily Republic Syndicated Content | From Page: B4

Crossword

By Daily Republic Syndicated Content | From Page: B5

 
Sudoku

By Daily Republic Syndicated Content | From Page: B5

Word Sleuth

By Daily Republic Syndicated Content | From Page: B5

 
Cryptoquote

By Daily Republic Syndicated Content | From Page: B5

Bridge

By Daily Republic Syndicated Content | From Page: B5