Oral Surgery for the Medically Complex Patient Flashcards
Illnesses associated with bleeding problems.
- Leukemia
- Liver disease
- Hemophilia
- Congenital Heart Disease
Different thromboplastin reagents have different sensitivities, resulting in widely varying what?
Prothrombin time
This normalizes PT values no matter which thromboplastin is used to generate it.
INR
High intensity protocol for anticoagulation.
Heart valve replacement
Standard protocol for taking anticoagulants.
1) Atrial fibrillation
2) Myocardial infarction
3) Pulmonary embolism
When a blood clot travels to the lung.
Pulmonary embolism
An irreversible anti-platelet drug.
Aspirin
A reversible anti-platelet drug.
NSAIDs
Anti-platelet drugs.
Aspirin and NSAIDs
The lifespan of a platelet
10 days.
What did Dr. campbell’s research on antiplatelets and blood loss during oral surgery discover?
There was no difference in blood loss between those taking anti-platelets at the time of surgery, and those who stopped taking them 10 days before surgery.
A structural analog of Vit. K
Coumadin
Warfarin is active how many days after you last take it?
2-3 days.
What does Warfarin inhibit?
Vit. K dependent extrinsic pathway.
Factors affected in the extrinsic pathway.
2, 7, 9, and 10.
Do Warfarin patients bleed more than those who don’t take Warfarin?
NO!
Directly inhibits Thrombin
Pradaxa
This patient is on Eliquis/Apixaban
Margaret
Another name for Eliquis
Apixaban
Newer anti-coagulant that prevents DVT.
Xarelto
This can complicate bleeding after an operation.
Post-perative infection
Consider giving this after an operation to avoid post-operative infection that can complicate bleeding.
Antibiotic prophylaxis
This injection increases your chances of having a bleeding problem.
Block
Contains activated Thrombin to control bleeding.
GelFoam
Used to rinse the wound to control bleeding.
5% Transexemic acid
Used to control bleeding that’s coming from the bone.
GelFoam or Bone wax
Controls bleeding that’s coming from the tissue.
Surgicel
Ligation
Cautery
When do you refer patients?
When you can’t provide as good a standard of care as a specialist would.
