Management of atrial fibrillation: the NICE guidelines.
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Biomedical subjects
Publications and source records attributed to Puneet Kakar.
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The need to consider myocarditis as one cause of flu-like symptoms in patients taking clozapine should be well entrenched. Suspicion should be heightened if the symptoms develop during the first 6-8 weeks of therapy. The FDA and the drug's manufacturer have strengthened warnings to include that a potentially fatal myocarditis may occur when taking clozapine. We aim to highlight the side effects of clozapine and increase awareness of this condition associated with the usage of the drug.
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There is overwhelming evidence from randomized trials and systematic reviews to indicate the benefit of thromboprophylaxis in patients with atrial fibrillation. In moderate- to high-risk subjects, oral anticoagulation with warfarin reduces stroke by two-thirds, while aspirin reduces stroke by 22%. The latter result is similar to that seen for stroke reduction with antiplatelet therapy in vascular disease. Numerous studies have shown that less than half the patients eligible for warfarin therapy actually receive it and under- or overanticoagulation is common. This leads to many missed opportunities in optimizing stroke prevention in atrial fibrillation. The limitations of existing oral anticoagulants have resulted in the development of many new drugs. The aim of this review is to provide a brief overview of thromboprophylaxis in atrial fibrillation, and the opportunities for improvement in the provision made for thromboprophylaxis.
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