7.1j: Anticoagulant Therapy
Oral anticoagulant (OA) treatments usually follow initial heparin treatment for DVT or PE, as a way of maintaining therapy. These treatments can be commenced as soon as the diagnosis is obtained. The initial duration should be a total of 3 months. The International Normalised Ratio (INR) system for monitoring warfarin therapy involves dividing the PT of a test sample by the mean normal PT and raising this to the power of the ISI of the thromboplastin used.
(In determining INR various principles of instrumentation are used to ensure accuracy.?? Firstly, is on instrument – reagent combinations, which are contrary to those of manufacturers specifications.?? Another principle of instrumentation is on the use of insensitive thromboplastins, which have high ISI values.??)NOT SURE WHAT YOU ARE TRYING TO SAY HERE
The reference ranges for normal patients is usually 0.8-1.2, while THE THERAPUTIC RANGE IS 2.0 TO 4.5 DEPENDING ON THE REASON FOR WARFARINISATION abnormal ranges may cause over bleeding in patients WHAT IS THE PURPOSE OF THE ISI? WHY IS A LOW ISI PREFERABLE? WHY MIGHT A PERSON BE PUT ON WARFARIN APPART FROM DVT/PE? WHAT ARE THE SIDE EFFECTS AND COMPLICATIONS? WHY IS HEPARIN USED INITIALLY?
The principles of monitoring heparin anticoagulant therapy are mostly influenced by the varying responses of different patients TO DOSES OF HEPARIN with thromboembolic disorders. Monitoring is BY measurements OF by changes in the aPTT. HOW DOES IT HAVE ITS ANTICOAGULANT EFFECT? DIFFERENCE BETWEEN LOW MOLECULAR WEIGHT HEPARIN AND UNFRACTIONATED HEPARIN?
Principles of direct thrombin inhibitor (DTI) therapy involve intravenously NO!!!!! DTI’s ARE TAKEN ORALLY!!! taking the medication WITH THERAPUTIC LEVELS ACHIEVED AFTER AROUND TWO HOURS with activated clotting times (ACT) achieved after five minutes. HOW AND WHEN ARE DTI’s MONITORED? Both internal and external quality assurance are centred at ensuring compliance and training staff of new developments.
INTERNAL QC SAMPLES, NO NEQAS AS YET

HOW DO DTI’s HAVE THERE ANTICOAGULANT EFFECT?
NAME SOME DTI’s