Hematologic perturbations associated with salicylate

Rothschild, Bruce M.

doi:10.1002/cpt1979262145

Cited by 44 publications

(12 citation statements)

References 8 publications

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“…Some drugs potentiate the anticoagulant effect, resulting in an increased prothrombin time and risk of bleeding. These drugs include phenylbutazone,l42-44] cimetidine,l45-47] metronidazole, [48] allopurinol, [49] aspirin, [50][51][52] retoprofen)53] meclofenamic acid (meclofenamate))54] phenytoin,l55] dextroproproxyphene,[56J" quinidine, [57] sulindac, [58,59], erythromycin,l60-63] norfloxacin [64] and thyroxine.l 65 ,66] Other drugs, such as barbiturates [67][68][69] and rifampicin (rifampin), [70][71][72] increase hepatic metabolism, which decreases the anticoagulant effect, thereby increasing the dosage requirements. Discontinuation of these drugs Aspirin and other nonsteroidal anti-inflammatory drugs inhibit platelet cyclo-oxygenase which may impair platelet aggregation, [73][74][75][76][77] and they may cause gastric mucosallesions,178-84] These 2 factors probably account for the increased risk of bleeding in patients taking these drugs during anticoagulant therapy.…”

Section: Reasons Why Older Patients May Be At Increased Risk For Antimentioning

confidence: 99%

Anticoagulants in Older Patients

Beyth

Landefeld

1995

Drugs & Aging

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Although anticoagulants are beneficial in the prevention and management of many thromboembolic disorders, they can cause serious bleeding. However, the risk of anticoagulant-related bleeding is not clearly defined for older patients, who are likely to benefit the most from anticoagulant therapy. Older patients may be at increased risk for anticoagulant-related bleeding because of their increased incidence of adverse drug reactions, increased prevalence of comorbidity and polypharmacy and increased vascular and endothelial fragility. Furthermore, the anticoagulant effect of warfarin is increased in older patients. Therefore, it is important to determine whether or not heparin-related and warfarin-related bleeding are more common in older patients. Most studies that have examined age as a risk factor for heparin-related bleeding have found bleeding to be more frequent in older patients: patients 60 years and older were approximately 3 times as likely to develop bleeding during heparin therapy than were younger patients. Studies that have examined age as a risk factor for warfarin-related bleeding have found conflicting results. Seven studies, enrolling a total of 14,388 patients, found that older patients were approximately twice as likely to bleed during warfarin therapy. In contrast, 7 studies, enrolling a total of 2940 patients, found no increase in the frequency of warfarin-related bleeding in older patients. These findings provide a basis for weighing the risks of anticoagulant therapy and for making decisions about the use of anticoagulants in older patients. These findings also indicate the potential value of methods to decrease the frequency of anticoagulant-related bleeding in older patients. Such methods include maintaining the anticoagulant effect within the therapeutic range and recognising other modifiable factors, such as medication use, that may promote bleeding.

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Section: Reasons Why Older Patients May Be At Increased Risk For Antimentioning

confidence: 99%

Anticoagulants in Older Patients

Beyth

Landefeld

1995

Drugs & Aging

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“…The anticoagulant effect of warfarin is augmented by the second-and third-generation cephalosporins, which inhibit the cyclic interconversion of vitamin K 51,52 ; by thyroxine, which increases the metabolism of coagulation factors 50 ; and by clofibrate, through an unknown mechanism. 53 Doses of salicylates Ͼ1.5 g per day 54 and acetaminophen 55 also augment the anticoagulant effect of warfarin, possibly because these drugs have warfarin-like activity. 56 Heparin potentiates the anticoagulant effect of warfarin but in therapeutic doses produces only slight prolongation of the PT.…”

Section: Pharmacokinetics and Pharmacodynamics Of Warfarinmentioning

confidence: 99%

American Heart Association/American College of Cardiology Foundation Guide to Warfarin Therapy

Hirsh¹,

Fuster²,

Ansell³

et al. 2003

Circulation

704

542

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“…This earlier recognition may have allowed patients to take aspirin earlier in their attacks. It appears that aspirin itself, rather than the salicylate derived from it, is required for an antiplatelet effect (4). Thus, the present study raised the possibility that one key to successful aspirin therapy in migraine may be the rapid delivery of unhydrolyzed aspirin into the circulation as early as possible in the course of a migraine attack.…”

Section: Discussionmentioning

confidence: 79%

Aspirin Treatment of Migraine Attacks: Clinical Observations

1982

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A retrospective study of the efficacy of soluble aspirin in migraine has been carried out. Data were available for 61 patients. These patients differed in only relatively minor ways from the remainder of the population of migraine sufferers referred to a neurological consultative practice. Soluble aspirin usually or always relieved migraine attacks in 44% of these patients, and sometimes relieved the disorder in another 25%. Adverse effects mainly nausea and vomiting, were reported by 16% of patients only, and in some cases nausea and vomiting may have been due to migraine rather than to the drug. Response to aspirin was unrelated to factors such as the patient's age, sex and duration of migraine history, and to the severity of migraine or occurrence of nausea and vomiting during attacks. However, the presence of a migraine aura appeared to improve the chances of a response to aspirin. The aura may have permitted earlier recognition that migraine was present, and thus allowed earlier aspirin intake at a stage when it had a better chance of influencing migraine mechanisms.

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Hematologic perturbations associated with salicylate

Cited by 44 publications

References 8 publications

Anticoagulants in Older Patients

Anticoagulants in Older Patients

American Heart Association/American College of Cardiology Foundation Guide to Warfarin Therapy

Aspirin Treatment of Migraine Attacks: Clinical Observations

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