Atrial Fibrillation and

PRADAXA

Jaclyn Davis, RN
Concordia College
NUR 331: Prevention,
Health Promotion & Risk
Reduction
What is Atrial Fibrillation?
Atrial fibrillation is a common heart condition that
affects approximately 2.5 million Americans
every year.
Atrial fibrillation requires immediate medical
attention. If not treated, it can lead to life-
threatening strokes.
The treatment of atrial fibrillation may require
long-term medication and possibly electroshock
to the heart.



Normal Sinus Rhythm
Normally, your heart contracts
and relaxes to a regular beat,
60 to 100 bpm.

Certain cells in your heart make
electric signals that cause the
heart to contract and pump
blood.

These electrical signals show
up on an electrocardiogram
(ECG) recording.

Your doctor can read your ECG
to find out if the electric signals
are normal.


Atrial Fibrillation
In atrial fibrillation (AF or AFib),
the hearts two small upper
chambers (atria) of the heart
dont beat the way they should.
Instead of beating in a normal
pattern, the atria beat
IRREGULARLY and TOO
FAST, quivering like a bowl of
gelatin.
The heart rate can be between
80 and 160 beats per minute.
Atrial Fibrillation
A RAPID and IRREGULAR
heart rate causes some
blood to remain in the heart
after every contraction.
This results in blood pooling
in the heart chambers, which
INCREASES the RISK of
BLOOD CLOT formation.
These blood clots can get
dislodged and travel to the
brain and lungs where they
could block the flow of blood.
When the flow of blood is
interrupted a fatal or
disabling stroke could occur.

Goal of Treatment
Multiple treatments for atrial
fibrillation work together to prevent:
Blood clots from forming
Control heart rate
Restore a normal heart rhythm
The Goal of Treatment is to:
Reduce the risk of stroke
Reduce the risk of heart failure
Improve the quality of life
In Atrial Fibrillation,
How Does the Heart Beat?
Answer: Fast and Irregular
What is a Goal for the
Treatment of Atrial Fibrillation?
Answer: Goal for Treatment in AF
Reduce the risk
of stroke
Reduce the risk
of Heart failure
Improve the
quality of life
Treating Atrial Fibrillation
with PRADAXA
What is Dabigatran (Pradaxa)?
Pradaxa is a new anticoagulant blood
thinner that reduces the risk of stroke
(blood clot in the brain) in patients with
atrial fibrillation.
It works by lowering the chance of forming
blood clots in your body.
Unlike warfarin, Pradaxa doesnt require
frequent blood testing or special dietary
considerations.
Pradaxa is available as a
capsule in doses of 75 mg and 150 mg
The usual dose of Pradaxa is
a 150-mg capsule twice a day.
For people with certain
types of kidney problems,
the dose may be decreased
to 75 mg twice a day.
Pradaxa Reduces the
Risk of ?
Answer: Stroke
True or False:
Pradaxa requires frequent blood
testing and special dietary
restrictions?
Pradaxa DOESNT require
frequent blood testing or
special dietary considerations.
How do I take Pradaxa?
1 capsule TWICE a day by
mouth
Swallow capsules whole
and do NOT open, break,
or chew the capsules
Can be taken with or without food
Be consistent with timing of doses,
and try to take the drug every 12
hours
What if I miss a dose?
Take your missed dose as soon as
you remember.
Skip the missed dose if it is less
than 6 hours before your next dose
is due.
Never take 2 doses together to make
up for a missed dose.
It is VERY important not to miss
doses because this increases your
risk of having a stroke.

How to Store Pradxa?
Once bottle is opened, you must
take all of the capsules within 60
days.
Keep the bottle tightly closed and
store in original package to protect
from moisture.
Do NOT put them in a pill box
(medi-set).

Do not stop taking
Pradaxa without first
talking to the doctor who
prescribes it for you.
Stopping Pradaxa may
increase your risk of a
stroke.
It is important that all your doctors
and dentists know that you take
Pradaxa.
Before having surgery or any
medical/dental procedures, tell
your doctor or dentist that you are
taking this medication.
Your doctor may tell you to stop this
medication before surgery.
Follow your doctor's directions
carefully.

Pradaxa is taken?
A. Three times a day
B. Once a day
C. Twice a day
D. At night time only

True or False:
Pradaxa can be stored
in a Pill Box?
Pradaxa is stored in its original
package.
DO NOT store in pill box.
Side Effects of Pradaxa
Possible common side effects include:
~ Nausea
~ Heartburn
~ Indigestion
~ Bruising
~ Bleeding (it may take longer for bleeding to stop).


Risk of stomach upset is highest during first few
weeks of treatment. If you experience stomach upset,
try taking the pill with food. If this does not help, talk to
your doctor.

Pradaxa can increase
your risk of bleeding
because it lessens the
ability of your blood to clot.
Call your doctor or get
medical help right away
if you have any of these
signs or symptoms of
bleeding.

Signs and Symptoms of
Bleeding:
Unexpected bleeding or bleeding
that lasts a long time, such as:
Unusual bleeding from the gums
Nose bleeds that happen often
Bleeding that is severe or you
cannot control
Pink or brown urine
Red or black stools (looks like tar)

Signs & Symptoms of
Bleeding cont
Bruises that happen
without a known
cause or get larger
Cough up blood or
blood clots
Vomit blood or your
vomit looks like
coffee grounds
Unexpected pain,
swelling, or joint pain
Headaches, feeling
dizzy or weak
A serious fall or injury
to your head

What is a Sign or Symptom for
Bleeding?
Answer: Signs & Symptoms of
Bleeding include..
Nose bleeds that happen
often
Bleeding that is severe or
you cannot control
Cough up blood
Bruises that happen
without a known cause or
get larger
Red or black stools
Pink or brown urine

Which Drugs Interact with
Pradaxa?
Blood thinners
Warfarin (Coumadin

)
Heparin
Aspirin
Clopidogrel (Plavix

)
Prasugrel (Effient

)
Non-steroidal anti-
inflammatory medicines
(ibuprofen, naproxen)
St. Johns Wort

Rifampin
Amiodarone, Quinidine,
dronedarone
(antiarrhythmic agent)
Verapamil (calcium
channel blocker)
Ketoconazole
(antifungal)
Chamomile, and red
clover

Do not take any
medicines unless they
have been discussed
with your doctor.
This includes
prescription or over-
the-counter medicines
and herbal or vitamin
supplements.
Name a Drug that Interacts
with Pradaxa?
A: Drugs that Interact with
Pradaxa include..
Aspirin
Warfarin (Coumadin

)
Non-steroidal anti-
inflammatory medicines
(ibuprofen, naproxen)
St. Johns Wort
Rifampin
Clopidogrel (Plavix

)
Prasugrel (Effient

)


References
American Heart Association. (2014, April). Atrial Fibrillation. Treatment and
Prevention of Atrial Fibrillation. Retrieved from http://www.heart.org/
HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Treatment-and-
Prevention-of-Atrial-Fibrillation_UCM_423778_Article.jsp

Engelke, Z. (2010, October 5). Nursing practice & skill. Patient Education:
Teaching the Patient about Oral Anti- coagulation Therapy. Retrieved
from
http://www.ebscohost.com/nursing/products/nursing-reference-center.

Lovecchio, C.P. (2011, May). A new oral anticoagulant hits the market.
American Nurse Today, 6(5), 49-51. Retrieved from
http://www.americannursetoday.com
National Stroke Association. (n.d.). Controllable Risk Factors. Atrial Fibrillation.
Retrieved from
http://www.stroke.org/site/PageServer?pagename=afib

Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2010). Brunner and Suddarth's
textbook of medical-surgical nursing. (12
th
ed.). Philadelphia:
Lippincott Williams & Wilkins.



References
University of Utah Health Care. (n.d.). Understanding atrial fibrillation. Diagnosis,
management and follow-up. Retrieved from
http://healthcare.utah.edu/cardiovascular/conditions/
understanding_atrial_fibrillation.pdf

U.S. Department of Veterans Affairs. (2013, July). Patient Education Information
Sheet. What is Dabigatran (Pradaxa)? Retrieved from http://
www.northflorida.va.gov