Update to Atrial Fibrillation: Anticoagulation and Social Anxiety Disorder

03 Mar Update to Atrial Fibrillation: Anticoagulation and Social Anxiety Disorder

All TreatGx users now have access to the updated treatment algorithms for Atrial Fibrillation – Anticoagulation and Anxiety – Social Anxiety Disorder.

Atrial Fibrillation – Anticoagulation

The updated atrial fibrillation anticoagulation algorithm provides a streamlined approach to medication options when initiating or switching between anticoagulants. Switching instructions have been updated to include specific information for each drug. This algorithm continues to provide personalized dosing and now includes an additional direct-acting oral anticoagulant, dabigatran.

This update includes information from local and international treatment guidelines for atrial fibrillation, including the American Heart Association, American College of Cardiology Foundation and Heart Rhythm Society 2019 guideline[1], the Canadian Cardiovascular Society and Canadian Heart Rhythm Society 2020 guideline[2], and the European Society of Cardiology 2020 guideline[3].

Anxiety – Social Anxiety Disorder

This comprehensive update incorporates information from the most recent clinical guidelines and literature from the New England Journal of Medicine[4], BMC Psychiatry[5], and the National Institute for Health and Care Excellence[6].

Highlights of the update: Three new medication options (clonazepam, phenelzine, and pregabalin) have been added based on the latest evidence for efficacy and safety. Side effect profiles have also been added for all medications

As always, both updates include the TreatGx standard of providing personalized dosing based on pharmacogenetics, kidney function, liver function, and drug interactions.

References

1. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, Jr., Ellinor PT, Ezekowitz MD, Field ME, Furie KL et al: 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart rhythm 2019, 16(8):e66-e93. 
2. Andrade JG, Aguilar M, Atzema C, Bell A, Cairns JA, Cheung CC, Cox JL, Dorian P, Gladstone DJ, Healey JS et al: The 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Comprehensive Guidelines for the Management of Atrial Fibrillation. Canadian Journal of Cardiology 2020. 
3. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castella M, Dan GA, Dilaveris PE et al: 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). European heart journal 2020. 
4. Leichsenring F, Leweke F: Social Anxiety Disorder. N Engl J Med 2017, 376(23):2255-2264. 
5. Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M, Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles a, McGill U, Antony MM, Bouchard S et al: Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry 2014, 14 Suppl 1:S1. 
6. National Collaborating Centre for Mental Health (Great Britain), National Institute for Health and Clinical Excellence (Great Britain): Social anxiety disorder : [the NICE guideline on] recognition, assessment and treatment. National clinical guideline number 159. 2014.