Anticoagulation Therapy

Name the clotting problem before naming the drug. A prevention regimen for embolic stroke in atrial fibrillation is not interchangeable with the intensified early regimen used for acute DVT or PE. A mechanical prosthetic valve creates a different prescribing boundary again. The bedside screen is sequential: confirm the indication, assess renal and hepatic clearance, look for active bleeding and interacting medicines, then choose the dose and monitoring plan. Apixaban is a useful model because it covers several common indications but still has hard limits, particularly severe bleeding, important hepatic disease, reduced creatinine clearance, and strong interacting drugs.