Haematology

Question 1

What oral health implications does warfarin have?

Answer 1

Blood thinner - may take longer to achieve haemostasis for extractions

Question 2

What oral health implications does simvastatin have?

Answer 2

May cause dry mouth - greater risk of caries or gum disease

Question 3

What oral health implications does Furosemide have

Answer 3

may cause dry mouth

Question 4

What oral health implications does metformin have?

Answer 4

dry mouth

Question 5

Haemophilia A cause

Answer 5

• Factor VIII deficiency

Question 6

Haemophilia B

Answer 6

Factor IX deficiency

Question 7

Von Willebrand’s disease

Answer 7

• reduced factor VIII level
• reduced platelet aggregation

Question 8

Warfarin mechanism of action

Answer 8

inhibits production of vitamin K dependent clotting factors

Question 9

How often should the iNR be checked in a patient on warfarin?

Answer 9

every 4-8 weeks

Question 10

INR normal reading

Answer 10

2-3

Question 11

INR stands for,,,

Answer 11

international normalised ratio

Question 12

DOAC mechanism of action

Answer 12

inhibition of factor X

Question 13

Examples of DOACs

Answer 13

• rivaroxiban
• apixaban
• edogaban
• dabigatran

Question 14

DOAC that needs to be taken twice daily

Answer 14

apixaban and dabigatran

Question 15

what type of drug is warfarin?

Answer 15

anti coagulant

Question 16

Management of a patient on warfarin prior to extraction

Answer 16

check INR no more than 24 hours before procedure (72 hours if patient stably anti coagulated)
if INR below 4 - treeat
delay if over 4

Question 17

Management of a patient on dabigatran or apixaban prior to extraction

Answer 17

miss morning dose
take usual time in the eventing

Question 18

Management of a patient on rivaroxaban or edoxaban prior to extraction

Answer 18

delay morning dose
- take 4 hours after haemostasis achieved (rivaroxiaban) or usual time in evening (edoxaban)