SCR - Anticoagulants SDCEP guidance Flashcards
Give examples of DOACs.
- apixaban
- dabigatran
- rivaroxaban
- edoxaban
Give examples of vitamin K antagonists.
Warfarin
Give examples of antiplatelet drugs.
- aspirin
- clopidogrel
- dipyridamole
What is considered a high bleeding risk procedure?
- complex XLA (3+ or adjacent)
- flap raising procedures
- gingival recontouring
- biopsy
What is considered a low bleeding risk procedure?
- simple XLA (<3, not adjacent)
- incision and drainage of swelling
- 6PPC
- subgingival PMPR
- restorations with subgingival margins
What is considered a procedure with no bleeding risk?
- LA
- BPE
- supragingival PMPR
- restorations with supragingival margins
- RCT
- impressions
- orthodontic appliances
Which DOACs are taken twice daily?
- apxiaban
- dabigatran
Which DOACs are taken once daily?
- edoxaban
- rivaroxaban
What is the guidance for a low risk procedure for a patient taking apixaban?
Treat without interrupting medication
What is the guidance for a low risk procedure for a patient taking dabigatran?
Treat without interrupting medication
What is the guidance for a low risk procedure for a patient taking edoxaban?
Treat without interrupting medication
What is the guidance for a high risk procedure for a patient taking apixaban?
Miss morning dose
What is the guidance for a high risk procedure for a patient taking dabigatran?
Miss morning dose
What is the guidance for a low risk procedure for a patient taking rivaroxaban?
Treat without interrupting medication
What is the guidance for a high risk procedure for a patient taking rivaroxaban?
Delay morning dose, wait until 4 hours after haemostasis achieved to take dose
What is the guidance for a high risk procedure for a patient taking edoxaban?
Delay morning dose, wait until 4 hours after haemostasis achieved to take dose
When should the INR be checked?
- <24 hours ideal
- <72 hours if patient is stable
What is the target range for the INR?
2-4
What INR score indicates it is safe to treat patients?
<4
What is the advice for patients taking aspirin alone?
Treat without interrupting medication
What is the advice for patients taking aspirin in combination with another antiplatelet?
Treat without interrupting medication
What is the advice for patients taking clopidogrel?
Treat without interrupting medication
What is the advice for patients taking dipyridamole?
Treat without interrupting medication
What is the advice for patients taking antiplatelet and anticoagulant medication?
Consult prescribing clinician
What medical conditions are associated with increased bleeding risk?
- chronic renal failure
- heart failure
- liver disease
- haematological malignancy
- recent radio/chemotherapy
- coagulation disorders
- CTD
What is the mode of action of warfarin?
Vitamin K antagonist
What is the mode of action of apixaban?
Factor 10a inhibitor
What is the mode of action of edoxaban?
Factor 10a inhibitor
What is the mode of action of rivaroxaban?
Factor 10a inhibitor
What is the mode of action of dabigatran?
Direct thrombin inhibitor (factor 11a)
What is the mode of action of aspirin?
COX-I and COX-II inhibitor
