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Pharmacist Specialist, Department of Pharmaceutical Services, University of California, Davis Medical Center, Sacramento, CA; Clinical Professor of Pharmacy, School of Pharmacy, University of California at San Francisco; Clinical Professor of Medicine, School of Medicine, University of California Davis
Reprints: Dr. Dager, Department of Pharmaceutical Services, University of California, Davis Medical Center, 2315 Stockton Blvd., Sacramento, CA 95817, fax 916/703-4031, william.dager{at}ucdmc.ucdavis.edu
Developing dosing management guidelines or protocol approaches to pharmacotherapy can provide several benefits for standardization of care. Frequently, clinicians may need to incorporate multiple influencing factors to individualize management. In some cases, preestablished, standardized approaches may create barriers to individualized care, potentially categorizing patients into dosing categories (silos) that minimize their individualized needs. Approaches to managing direct thrombin inhibitor therapy have been recently explored and dosing approaches different from those provided in the prescribing information have been proposed. Considerations regarding individualized management of anticoagulant therapy, including the use of standardized dosing or monitoring protocols, are discussed here.
Key Words: anticoagulation, dosing, nomograms
Published Online, January 6, 2009. www.theannals.com, DOI 10.1345/aph.1L526
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