Comments on: A genetic test for Coumadin http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html medical blog Wed, 17 Mar 2010 03:23:39 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79346 Anonymous Tue, 21 Aug 2007 17:58:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79346 Coumadin Test www.pgxhealth.com<br/>they help with reimbursement. Coumadin Test http://www.pgxhealth.com
they help with reimbursement.

]]> By: Marie http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79333 Marie Tue, 21 Aug 2007 07:46:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79333 ClotCare provides a thorough examination of this issue at:<br/><br/>http://www.clotcare.com/clotcare/warfaringenetictesting.aspx ClotCare provides a thorough examination of this issue at:

http://www.clotcare.com/clotcare/warfaringenetictesting.aspx

]]> By: Mike http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79304 Mike Tue, 21 Aug 2007 01:19:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79304 "genomically inept MD's"???<br/><br/>What the f&%^ are you talking about???<br/><br/>Anyway, the majority of INR check occur in a hospitalized setting, as these aptients usually need lovenox or UFH as well. And the follow ups are also typically more frequent as they are given a lot of follow ups after discharge. Also, coumadin clinics exist just for this sort of thing. “genomically inept MD’s”???

What the f&%^ are you talking about???

Anyway, the majority of INR check occur in a hospitalized setting, as these aptients usually need lovenox or UFH as well. And the follow ups are also typically more frequent as they are given a lot of follow ups after discharge. Also, coumadin clinics exist just for this sort of thing.

]]> By: Steve Murphy MD http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79221 Steve Murphy MD Sun, 19 Aug 2007 01:34:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79221 Check it once. Check an INR every week to two once stable. It only gives us a better starting point. The due diligence is still required to monitor patients. But at least you won't get the first month horror stories. You still need INRs, God I hope that "genomically inept" MDs won't assume they don't need INRs!!! This test and the dosing adjustment is only a stepping off point for personalized medicine. We still need to practice medicine, but this time smarter.<br/>-Steve<br/>www.thegenesherpa.blogspot.com<br/>www.helixhealth.org Check it once. Check an INR every week to two once stable. It only gives us a better starting point. The due diligence is still required to monitor patients. But at least you won’t get the first month horror stories. You still need INRs, God I hope that “genomically inept” MDs won’t assume they don’t need INRs!!! This test and the dosing adjustment is only a stepping off point for personalized medicine. We still need to practice medicine, but this time smarter.
-Steve
http://www.thegenesherpa.blogspot.com
http://www.helixhealth.org

]]> By: Mike http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79204 Mike Sat, 18 Aug 2007 20:14:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79204 Why is the genetic test better than checking INR's? I don't get it. Why is the genetic test better than checking INR’s? I don’t get it.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/08/genetic-test-for-coumadin.html/comment-page-1#comment-79172 Anonymous Fri, 17 Aug 2007 17:53:00 +0000 http://clients.emmense.com/kevinmd/2007/08/a-genetic-test-for-coumadin.html#comment-79172 Of course the only reason we need this test is because patients are being discharged much quicker than in the past. <br/>Anticoagulating patients back in my internship days meant daily or twice daily monitoring of the coagulation status, and determining the pharmacokinetics and pharmacodynamics on the fly. You don't need a genetic test to predict the response if you are adequately and in a timely manner measuring the response. <br/><br/>No reason as a doc to recoil at this new reccomendation. It helps with the realities of modern practice where I cannot keep the patient until the coags are stable. The DVT with PE now gets you 2 days stay only. Of course the only reason we need this test is because patients are being discharged much quicker than in the past.
Anticoagulating patients back in my internship days meant daily or twice daily monitoring of the coagulation status, and determining the pharmacokinetics and pharmacodynamics on the fly. You don’t need a genetic test to predict the response if you are adequately and in a timely manner measuring the response.

No reason as a doc to recoil at this new reccomendation. It helps with the realities of modern practice where I cannot keep the patient until the coags are stable. The DVT with PE now gets you 2 days stay only.

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