Bleeding Disorders Flashcards
Rivaroxaban - alterations for high risk bleeding procedure
delay morning dose if taken in morning normally. Resume 4 hours after haemostasis achieved
Apixiban or dabigatran - alterations for high risk bleeding procedure
miss morning dose. Take evening dose as normal
For a patient on warfarin - how long before a procedure should a patients INR be checked if they are stably anticoagulated.
ideally 24 hours. Can be up to 72 hours if they are stable.
What does INR need to be below?
4
Most common haemophillia?
A
What factor is deficient in haemophillia A?
Factor VIII
What factor is deficient in haemophillia B?
IX
What defines “moderate” haemophillia?
not many spontaneous bleeds but bleed after traume
What defines “mild” haemophillia?
only bleed after dental extractions, surgery or traume
Can carriers of haemophillia be affected?
female carriers may have low factor levels and may be at risk of bleeding
What considerations should be made regarding appointments and patients with haemophillia?
Schedule treatment appointments to be on same day as factor replacement.
What is Von Willebrands Disease?
Congenital bleeding disorder where there is reduced or abnormal plasma protein vWF. It is a autosomal dominant condition and affects females and males (types 1&2). Type 3 is autosomal recessive and can have more severe symptoms
What does vWF do?
Stabilises factor VIII and enables platelet interaction with the vessel wall
What is the dental management for someone with vWF?
Same as subcategories for haemophillia
Treatment for type 1 Von Willebrands disease
desmopressin (DDAVP)
