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Image transcription text Case Study = David Drummond This therapy is continued for four days, after which Mr Drummond is started on the following medication schedule: o warfarin so… Show more To guarantee adequate anticoagulation while switching from one anticoagulant to another, David is taking oral warfarin sodium and subcutaneous heparin for a few days. This procedure is called “Bridging anticoagulation” is the process of replacing a long-acting anticoagulant (warfarin) with a shorter-acting one (heparin sodium). Heparin is usually used to reduce the risk of subtherapeutic levels and thromboembolic events, especially in high-risk patients like David. Because of its quick effect, heparin sodium, when injected subcutaneously, produces instant anticoagulation. Whereas the oral anticoagulant warfarin sodium functions by blocking vitamin K epoxide reductase, which is required for the production of many clotting factors (I, VII, IX, and X) that depend on vitamin K for their function. In addition, David began taking the maintenance dosage of 10 mg of warfarin sodium daily. Since the blood already contains clotting components, the oral anticoagulant warfarin has a delayed beginning of action which can take several days to reach therapeutic levels. Then, a common procedure known as “bridging” involves giving heparin simultaneously with the commencement of warfarin therapy. As warfarin enters its effective therapeutic range, this tactic guarantees that David is impervious from clots. While warfarin accumulates to sufficient levels, heparin’s initial dosage provides instant protection against thromboembolic events. In conclusion, in order

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