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Suggest Treatment For Subdural Haematoma
Question: My mother is 93. She has A Fib and has been prescribed Plavix and also takes Multaq (two 400s) , hctz(25), metoprolol(50), nefidipine (90). The cardiologist said she should take Plavix and not warfarin because in 2013 mom was on warfarin and fell and had a subdural hematoma that required surgery. I want to know if Plavix is ok to take instead of warfarin due to the increased risk of a serious bleed if mom were to be on warfarin when she had another fall.
Brief Answer:
Please refer to the detailed answer below
Detailed Answer:
Hello Sir
Hope you remember me from our last conversation.
After going through the medical details provided by you of your mother I would like to tell you that considering her age and Gender her CHA2DS2 VAS score become minimum 3 may be more if she has diabetic or hypertension or previous stroke. This score is a high risk score for stroke risk.
Patients with this score should ideally be treated with warfarin according to the current guidelines.
So according to this she should be on warfarin instead of PLAVIX.
I hope this information will answer your query and will guide you properly.
Kind regards
Dr Bhanu partap
Please refer to the detailed answer below
Detailed Answer:
Hello Sir
Hope you remember me from our last conversation.
After going through the medical details provided by you of your mother I would like to tell you that considering her age and Gender her CHA2DS2 VAS score become minimum 3 may be more if she has diabetic or hypertension or previous stroke. This score is a high risk score for stroke risk.
Patients with this score should ideally be treated with warfarin according to the current guidelines.
So according to this she should be on warfarin instead of PLAVIX.
I hope this information will answer your query and will guide you properly.
Kind regards
Dr Bhanu partap
Above answer was peer-reviewed by :
Dr. Kampana
Thank you doctor Partap. Let me ask a follow up question. Can you explain to me why it is important to be on warfarin and not Plavix. The reason given to be on Plavix now and not warfarin was because she uses a walker all the time now to ambulate, she is not particularly steady when walking , and in year 2013 ,while on warfarin, fell and hit her head , resulting in subdural head surgery. They thought warfarin use was a contributing factor to the seriousness of fall
Brief Answer:
Hello Again
Detailed Answer:
I will try to explain the difference among these two drugs in a simple way.
PLAVIX contains clopidogrel which basically is an antiplatelet drug on the other hand Warfarin is a vitamin k antagonist or simply anticoagulant which helps in preventing clot formation.
As warfarin is much more effective in preventing clot formation especially in patients with AF as proved in several studies conducted through out the world.
However the reason for which she is on PLAVIX is acceptable as the risk of bleeding is high with warfarin. But it should be kept in mind that PLAVIX has an inferior protection towards stroke.
Dabigatran is a good alternative in her situation as it has lower bleeding risk than warfarin but similar stroke preventing abilities as that of warfarin. You can discuss this with her treating cardiologist.
I hope this information will answer your query and will guide you properly.
Kind regards
Dr Bhanu partap
Hello Again
Detailed Answer:
I will try to explain the difference among these two drugs in a simple way.
PLAVIX contains clopidogrel which basically is an antiplatelet drug on the other hand Warfarin is a vitamin k antagonist or simply anticoagulant which helps in preventing clot formation.
As warfarin is much more effective in preventing clot formation especially in patients with AF as proved in several studies conducted through out the world.
However the reason for which she is on PLAVIX is acceptable as the risk of bleeding is high with warfarin. But it should be kept in mind that PLAVIX has an inferior protection towards stroke.
Dabigatran is a good alternative in her situation as it has lower bleeding risk than warfarin but similar stroke preventing abilities as that of warfarin. You can discuss this with her treating cardiologist.
I hope this information will answer your query and will guide you properly.
Kind regards
Dr Bhanu partap
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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