anti-coagulation Flashcards
what is an example of injectable anticoagulant?
heparin
is a low molecular heparin dentally relevant?
no- it is a short term subcutaneous injection
what are examples of oral anticoagulants?
warfarin
rivaroxaban
apixiban
what are high risk procedures in dental setting?
biopsy
complex extraction
flap raising procedures
what are low risk procedures?
simple extraction
rsd
subgingival restorations
what procedures are unlikely to carry a bleeding risk?
supra restoration
pros
Endodontics
bpe
IBD
LA
what common conditions require anticoagulants?
atrial fibrillation
mechanical heart valves
DVT
thrombophilia
does warfarin have a slow or fast onset?
slow- increased risk of clot at start of treatment
what would be given if a patient on warfarin had excessive bleeding post surgery?
vitamin k injection
what does INR stand for?
international normalised ration
what does INR measure?
prothrombin- time taken for blood to clot
what is the normal INR for warfarin users ?
2-3
what is the INR of warfarin users with prosthetic valves/DVT?
3-4
when should INR be checked before treatment?
no more than 72 hrs before but 24hrs before is best
how often should INR be checked?
every 4-8 weeks
what does SDCEP say is an ok INR to proceed?
below 4- proceed with caution
what should be checked alongside INR before invasive treatment?
INR and FBC
when is it best to treat patients taking anticoagulants?
in the morning at the start of the week
what local haemostatic measures should used when treating patients?
LA- around socket to reduce blood flow
cellulose sponge
sutures
what should be given post op?
post op instructions
out of hours number
what drugs increase the action of warfarin?
NSAIDS
antibiotics
alcohol
anti fungal- “azoles”
aspirin
what does NOAC stand for?
new oral anticoagulants
do NOAC have rapid or slow onset?
rapid
do NOAC require monitoring/INR?
no
