The Use ???of Vitamin K in Patients on Anticoagulant Therapy

Hanslik, Thomas; Prinseau, J

doi:10.2165/00129784-200404010-00005

Cited by 46 publications

(26 citation statements)

References 61 publications

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“…The oral anticoagulant preferred for the outof-hospital anticoagulation was the AVK acenocumarol, an old drug and less costly option for PTE patients from Romania [21]. LMWH at discharge 242 was prescribed to 4 patients with active cancer as recommended by the current guideline.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary thromboembolism in an emergency hospital: Are our patients different?

Balahura

Guta

Mihalcea

et al. 2017

Romanian Journal of Internal Medicine

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Introduction. Pulmonary thromboembolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania.Material and methods. We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 -December 2016. Patients with acute PTE were identified by a database search of the diagnostic codes of all discharge diagnoses. Demographic, clinical and paraclinical tests data was retrieved from medical records.Results. 221 patients (48.87% male, mean age 61.76 years (range 21-94 years)) were diagnosed with PTE in our hospital (0.31% of all hospitalizations). Dyspnea was the most frequent symptom reported (78.9%), followed by pleuritic chest pain (23.9%) and unilateral leg pain (15.8%). Upon presentation, 12.6% of patients had high-risk PTE. Up to 72.8% of patients had at least one thrombotic risk factor, while cancer (14%) was the most frequent amongst them. The mean length of hospitalization was 10.3 ± 4.6 days. Unfractioned heparin (UFH) was the preferred anticoagulant during hospital stay (73.7%, p < 0.001). Vitamin K antagonists (AVK) were the preferred anticoagulant (71.7%, p < 0.001) after discharge, whereas non-antivitamin K oral anticoagulants (NOAC) were recommended in 26.3% of patients. Thrombolysis was used in 18 (8.4%) cases. Mortality was 0.9%.Younger patients more frequently associated thrombophilia or a previous thromboembolic event and clinical signs of DVT at presentation. Older patients associated more frequently a history of hospitalization for heart failure or atrial fibrillation during the previous 3 months and a history of cancer. The clinical presentation in older patients was more severe, with higher PESI scores (103.6 ± 33.4 vs. 55.5 ± 17.9, p<0.001) and a longer hospital stay (10.7 ± 4.7 vs. 9.2 ± 3.9, p = 0.03). The type of anticoagulant treatment did not differ depending on age.Conclusion. In our emergency hospital, PTE is a relatively rare cause of hospitalization; the rate is, however, comparable with other major hospitals. Dyspnea and pleuritic chest pain was the clinical presentation dyad. UFH was the preferred anticoagulant for in-hospital treatment while AVK was the preferred option for long term treatment and recurrence prophylaxis; however an increasing number of patients are prescribed NOAC. In older patients clinical severity was higher upon presentation, hospitalization duration was increased and cancer was more frequently associated. Younger patients associated more frequently a primary hypercoagulable state and recurrent thromboembolism. Mortality rate was low during hospitalization, comparable with that seen in other studied populations.

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Section: Discussionmentioning

confidence: 99%

Pulmonary thromboembolism in an emergency hospital: Are our patients different?

Balahura

Guta

Mihalcea

et al. 2017

Romanian Journal of Internal Medicine

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“…16) Hanslik, et al confirmed that the use of vitamin K in patients with warfarin over-anticoagulation lowers excessively elevated INR faster than withholding warfarin alone. 17) Willms, et al found that low-intensity warfarin (INR 1.5-2.1) was safe and effective to reduce the likelihood of major hemorrhagic or ischemic events in patients with non-valvular AF during the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Periprocedural Anticoagulation of Patients Undergoing Pericardiocentesis for Cardiac Tamponade Complicating Catheter Ablation of Atrial Fibrillation

et al. 2015

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SummaryAnticoagulation of patients with cardiac tamponade (CT) complicating catheter ablation of atrial fibrillation (AF) is an ongoing problem. The aim of this study was to survey the clinical practice of periprocedural anticoagulation in such patients. This study analyzed the periprocedural anticoagulation of 17 patients with CT complicating AF ablation. Emergent pericardiocentesis was performed once CT was confirmed. The mean drained volume was 410.0 ± 194.1 mL. Protamine sulfate was administered to neutralize heparin (1 mg neutralizes 100 units heparin) in 11 patients with persistent pericardial bleeding and vitamin K1 (10 mg) was given to reverse warfarin in 3 patients with supratherapeutic INR (INR > 2.1). Drainage catheters were removed 12 hours after echocardiography confirmed absence of intrapericardial bleeding and anticoagulation therapy was restored 12 hours after removing the catheter. Fifteen patients took oral warfarin and 10 of them were given subcutaneous injection of LMWH (1 mg/kg, twice daily) as a bridge to resumption of systemic anticoagulation with warfarin. Two patients with a small amount of persistent pericardial effusion were given LMWH on days 5 and 13, and warfarin on days 6 and 24. The dosage of warfarin was adjusted to keep the INR within 2-3 in all patients. After 12 months of follow-up, all patients had no neurological events and no occurrence of delayed CT. The results showed that it was effective and safe to resume anticoagulation therapy 12 hours after removal of the drainage catheter. This may help to prevent thromboembolic events following catheter ablation of AF. (Int Heart J 2015; 56: 56-61)

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“…3,6 A vitamina K pode ser administrada por via intravenosa (IV), subcutânea (SC), intramuscular (IM) ou oral (VO). 3,6,7 A administração por via oral da vitamina K é efetiva e tem, como vantagem, ser mais segura e conveniente que a via parenteral. 7 No Brasil, estão disponíveis, atualmente, apenas apresentações por via parenteral da vitamina K em monoterapia, sendo que o Kanakion® MM solução injetável 2mg/0,2mL é a única apresentação registrada que permite o uso por via oral, além do uso por via intravenosa e intramuscular.…”

Section: Introductionunclassified

“…3,6,7 A administração por via oral da vitamina K é efetiva e tem, como vantagem, ser mais segura e conveniente que a via parenteral. 7 No Brasil, estão disponíveis, atualmente, apenas apresentações por via parenteral da vitamina K em monoterapia, sendo que o Kanakion® MM solução injetável 2mg/0,2mL é a única apresentação registrada que permite o uso por via oral, além do uso por via intravenosa e intramuscular. Todas as outras apresentações disponíveis no mercado (Eskavit®, Kavit®, Vikatron®, Vita K®, Menadion®) são de uso por via intramuscular, intravenoso ou subcutâ-neo, não constando em bula qualquer informação quanto ao uso oral dessas apresentações.…”

Section: Introductionunclassified

Implantação de um centro de informações sobre medicamentos em uma secretaria estadual de saúde

Costa¹,

Souza²,

Catanheide³

et al. 2022

JAFF

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Objetivo: Descrever o caso da implantação do Centro de Informação de Medicamentos (CIM) da Secretaria Estadual de Saúde da Bahia (CIMBAHIA), no período de 2007 a 2110. Método: Estudo de caso sobre a implantação de um centro de informação sobre medicamentos na Secretaria Estadual de Saúde da Bahia (SESAB) no período de 2007 a 2010. Discussão: O papel e a necessidade de um centro de informação sobre medicamentos na Secretaria de Saúde do Estado da Bahia (SESBA) é determinado, como estratégia de enfrentamento ao crescimento dos campos da assistência farmacêutica pública e ATS no Brasil e à crescente demanda da sociedade por essas tecnologias, favorecendo uma avalanche de demandas judiciais junto ao SUS. Conclusão: O estudo demonstra a relevância da criação e operação do CIMBAHIA, preenchendo uma lacuna de conhecimento e de experiência sobre a implantação de um CIM no âmbito de uma secretaria estadual de saúde.

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The Use ???of Vitamin K in Patients on Anticoagulant Therapy

Cited by 46 publications

References 61 publications

Pulmonary thromboembolism in an emergency hospital: Are our patients different?

Pulmonary thromboembolism in an emergency hospital: Are our patients different?

Periprocedural Anticoagulation of Patients Undergoing Pericardiocentesis for Cardiac Tamponade Complicating Catheter Ablation of Atrial Fibrillation

Implantação de um centro de informações sobre medicamentos em uma secretaria estadual de saúde

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