Antithrombotic Drugs: Pharmacology and Implications for Dental Practice

Abstract

Appropriate preoperative assessment of the dental patient should always include an analysis of the patient's medications. This article reviews the actions and indications for the various categories of antithrombotic medications and considers actual risks for postoperative bleeding and potential interactions with drugs the dental provider might administer or prescribe.

A Systematic Review of the Hemorrhage Risk for Patients on Antithrombotic Medication after Dental Procedures

“…Consequently, they are more common in patients presenting to the dental practitioner. 1 In recent years, in the United Kingdom, besides the popular anticoagulant warfarin and antiplatelet agents, such as aspirin and clopidogrel, new oral anticoagulants and antiplatelet therapies have been made available, such as apixaban, dabigatran, and rivaroxaban.…”

“…The high-risk group of patients includes those who have had experienced deep vein thrombosis, pulmonary embolism, stroke, or have a cardiac arrhythmia that predisposes patients to clot formation. 1 As the number of antithrombotic medication prescriptions has increased in the last few years, the chances of having a patient in the dental surgery and taking them have increased considerably. 1 Combined therapy using both antiplatelet and anticoagulant medications increases the risk of spontaneous as well as postsurgical hemorrhage.…”

“…1 As the number of antithrombotic medication prescriptions has increased in the last few years, the chances of having a patient in the dental surgery and taking them have increased considerably. 1 Combined therapy using both antiplatelet and anticoagulant medications increases the risk of spontaneous as well as postsurgical hemorrhage. 1 Warfarin, a synthetic derivative of coumarin, is a vitamin K antagonist.…”

“…1 Combined therapy using both antiplatelet and anticoagulant medications increases the risk of spontaneous as well as postsurgical hemorrhage. 1 Warfarin, a synthetic derivative of coumarin, is a vitamin K antagonist. It has been used as oral anticoagulants for more than 60 years.…”

Extração dentária em pacientes com doença arterial coronariana em terapia antiplaquetária dual

“…De uma forma geral, os autores que propõe a suspensão do AAS apontam para a necessidade de fazê-lo de 7 a 10 dias antes do procedimento cirúrgico, já que levam em conta a meia vida da plaqueta e que a alteração provocada pelo AAS é irreversível (Conti, 1992;Scher, 1996;Sonis et al, 2003) Alguns autores como Little et al (2002) (Becker, 2013). Por outro lado, (Brennan et al, 2008;Minematsu, 2009;Morimoto et al, 2011;Fakhri et al, 2013) (Grines et al, 2007).…”