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Although warfarin is used less frequently today, it remains essential for many patients, and reduced day‑to‑day exposure can make its management even more challenging.
Join the CLOT Group- Ava Azhir, Darcy Lamb, and Tammy Bungard- on March 24 to refresh your warfarin management skills and build confidence in today’s evolving anticoagulation practice.
By the end of this session, participants will be able to:
— Identify current uses/indications and challenges for warfarin.
— Perform initial warfarin dosing based on patient characteristics, subsequent INR changes, and prior warfarin responses.
— Demonstrate appropriate adjustment of warfarin maintenance doses and determine appropriate INR frequency based on the following: INR trends, prior warfarin clinical responses, and rationale for out of range INR.
— Implement critical INR management and select reasonable warfarin dosing post-critical INR management.
About the speakers
Ava Azhir
— Dr. Ava Azhir, BSc. Pharm, ACPR, PharmD, BCACP, R. Ph is a clinical pharmacy specialist with extensive expertise in anticoagulation management. She currently serves as the Lead of the Anticoagulation Management Clinic at the Jim Pattison Outpatient and Surgery Care Center in Surrey, British Columbia. Dr. Azhir earned her Doctor of Pharmacy from the University of Toronto and completed an Accredited Canadian Pharmacy Residency with Lower Mainland Pharmacy Services. She has cultivated a diverse clinical background, spanning internal medicine, infectious diseases, nephrology, and cardiology, with a focus on evidence-based anticoagulation therapies. She is an active researcher and educator, having contributed to numerous studies and quality improvement projects on anticoagulation, venous thromboembolism, and direct oral anticoagulant prescribing patterns. Her work has been published in medical journals and presented at national and international conferences. Dr. Azhir is a dedicated member of the Collaborative Learning on Thrombosis (CLOT) group and the Canadian Society of Thrombosis, where she collaborates with experts in thrombosis management and research. She also serves as a clinical instructor, mentoring pharmacy students and residents at the University of British Columbia and the University of Toronto.
Darcy Lamb
— Darcy completed both his Bachelor’s and Master’s of Science in Pharmacy degrees at the University of Saskatchewan, as well as a hospital pharmacy residency in Regina, Saskatchewan. For the majority of his career, he has been a Primary Health Pharmacist working in a number of Primary Health Centres within Saskatoon and surrounding area. He also spent 10 years as the co-ordinator of the Saskatoon Anticoagulation Management Service. In 2023, he transitioned to the inpatient world and is currently a Clinical Pharmacy Specialist in neurology within the interdisciplinary stroke team at Royal University Hospital in Saskatoon.
Tammy Bungard
— Dr. Bungard graduated from the University of Saskatchewan with great distinction, completed a general practice residency at the Red Deer Regional Hospital Centre, then her PharmD at Wayne State University (Detroit, Michigan). In Edmonton, she completed a research fellowship funded by the Alberta Heritage Foundation for Medical Research. Currently, she is a tenured Full Professor of Medicine, Division of General Internal Medicine, University of Alberta. She has been an advocate for advancing pharmacist practice, having initiated the Anticoagulation Clinic at the University of Alberta Hospital – a program that served as a key example for Alberta to obtain prescriptive authority for pharmacists. She participated in creating the prescribing model (still in place today) and the assessment process to be granted this privilege. Her research portfolio spans the use of antithrombotic therapies, pharmacist practices and clinical reviews/practice tools. She continues to have an active clinic practice with both the Anticoagulation and Thrombosis Clinics.