Antithrombotic drugs, which include antiplatelet and anticoagulant agents, prevent and treat many cardiovascular disorders and, as such, are some of the most commonly prescribed drugs worldwide.
However, these drugs have some pharmacological limitations due to the metabolism, interactions to drug or environment, and other factors. They may be ineffective to some patients, which requires finding an alternative treatment.
Also, treatment with antithrombotic drugs, particularly some vitamin K antagonists such as warfarin, may have unwanted side effects that include hemorrhagic stroke and gastrointestinal bleeding.
Increased knowledge of the pharmacology of antithrombotic drugs and the mechanisms underlying thrombosis is therefore required for successful treatment that carries the less risk for the patient.
Mobile apps can be valuable by providing necessary guidance to clinicians across specialties on how to manage anticoagulation therapy and assisting them in making clinical decisions.
Here, we list some of the best apps that provide reference, calculators, and guidelines on antithrombotic therapy.
MAQI2 Anticoagulation Toolkit app is an up-to-date, easy-to-use resource that assists clinicians in managing anticoagulation patients more safely and effectively.
The app was developed by the University of Michigan and its content is based on Anticoagulation Toolkit PDF, as well as several other published guidelines and clinical trials, from American Heart Association (AHA)/ACC, the European Society of Cardiology, and the CHEST guidelines.
MAQI2 app provides several calculators, including CHA2DS2-VASc that provides stroke risk scores, and HAS-BLED that estimates the risk of major bleeding for patients on warfarin for atrial fibrillation.
The app is available for free on Android and iOS.
AnticoagEvaluator app is similar to MAQI2 app. It's created by the American College of Cardiology (ACC) with the goal to help clinicians dealing with complex questions and decisions regarding anticoagulation therapy.
Similarly to MAQI2 app, AnticoagEvaluator app provides specific numbers on stroke and bleeding risk, as well as benefits and risks of therapy with oral anticoagulants, allowing healthcare providers to make clinical decisions, discuss therapy options with their patients and explain them the benefits and risks of such therapy.
AnticoagEvaluator is available for free on iOS and Android.
Certain oral anticoagulation therapy often comes with potential side effects that include hemorrhagic stroke and gastrointestinal bleeding.
Things may become even more complex for providers if their patients on anticoagulation therapy require invasive procedures or surgery that can increase the risk of bleeding, while withholding anticoagulants may increase the risk of thrombosis.
Providers need to know how to handle those patients, particularly they need to decide if they have to interrupt the anticoagulation therapy if they do when they can restart it, and finally should their patients be "bridged" with low molecular weight heparin?
BridgeAnticoag app tries to answer all these questions and provide clinicians with guidance on how to manage anticoagulation therapy in patients with non-valvular atrial fibrillation who are scheduled for invasive procedure or surgery.
The app is available for Android and iOS for free.
MAPPP app works similarly to BridgeAnticoag app. It also tries to assist clinicians in making educated decisions regarding the decision to interrupt oral anticoagulation for an invasive procedure or surgery and, if interrupted, whether to "bridge" anticoagulation with injectable anticoagulants, such as low molecular weight heparin (LMWH) in patients treated with warfarin.
MAPPP app also provides detailed guidance for drug dosing and laboratory monitoring in the peri-procedural period and encourages communications between clinical teams, i.e. clinicians who prescribe anticoagulants and surgical teams.
The app is free to download and use on Android and iOS devices.
ASRA Coags App
ASRA Coags app is designed to help clinicians make the complex decisions regarding the administration of various regional nerve blocks in patients receiving antithrombotic or thrombolytic therapy.
The app enables clinicians to search for drugs by generic or brand name, and simply select a particular anesthetic agent, type of nerve block, and desired intervention to view the American Society of Regional Anesthesia and Pain Medicine's (ASRA) evidence-based recommendations on timing, the use of anticoagulants, method of action for each drug, and other important clinical considerations.
The app is available for iOS and Android for $3.99.
WarfarinGuide app provides practicing clinicians involved in warfarin anticoagulation such as internists, cardiologists, family physicians, with three resources essential for evidence-based anticoagulation therapy with warfarin, a drug that comes with serious hemorrhagic stroke and gastrointestinal bleeding risks.
The app reviews the latest recommendations on indications, INR targets, and treatment duration from the American College of Chest Physicians guidelines, it provides a protocol for warfarin dose adjustment based on INR result, and finally, it discusses protocols for the initiation of warfarin.
WarfarinGuide app also links to 'sister' app called PreOpEval, which provides guidance for management of peri-operative warfarin.
The app is available for free, however, only on iOS.
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Heparin Dosing App
Heparin is an anticoagulant drug used to treat and prevent the formation of blood clots in the veins, arteries, or lung. Heparin is delivered intravenously (IV) or subcutaneously, and it is also used before surgery to reduce the risk of blood clots, or to 'bridge' oral anticoagulants (warfarin) in patients who are scheduled for surgery or invasive procedure.
Heparin Dosing app allows clinicians and nurses to calculate the starting dose of a heparin drip and suggests adjustments to the drip rate based on the current rate and aPTT.
Users use the app to define the starting bolus dose and rate and set maximum rate and bolus for the starting dose.
Heparin Dosing app makes these calculations using lean body weight, and it is based on the same guidelines provided by the American College of Chest Physicians.
The app is available for Android and iOS for $0.99.
Clot Rx App
Clot Rx app is a quick reference guide which provides clinicians with quick access to information on the use of antithrombotic therapy agents.
Users can navigate the app by condition or medication and get information on treatment and prevention of thromboembolic events, medication indication, dosing, mechanism of action, contraindications, and common adverse effects, evidence-based guidelines, and clinical decision tools supported by tables and algorithms.
The app is based on several antithrombotic and cardiovascular guidelines, including those from American College of Chest Physicians, AHA/ACC, and European Society of Cardiology.
Clot Rx is available on iOS devices for $1.99.
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