Use of Bishydroxycoumarin (Dicumarol®) in the Presence of Impaired Renal Function

Sachs, Julius J.

doi:10.1001/jama.1952.02930100057012

Cited by 21 publications

(2 citation statements)

References 6 publications

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“…32,33 Most studies have shown that patients with renal insufficiency have an increased risk of major bleeding during VKA treatment. [34][35][36] However, there is a lack of this association in our study; this could be that we have a few patients with Renal Insufficiency.…”

Section: Discussionmentioning

confidence: 71%

Frequency of bleeding complications in Algerian patients treated with the vitamin K antagonist acenocoumarol and associated factors

Belkacemi

Merad

Berber

2021

Int J Basic Clin Pharmacol

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Background: The major complication of vitamin K antagonist (VKA) therapy is bleeding. This study aimed to estimate the rate of hemorrhagic accidents and identify the hemorrhagic factors in Algerian patients treated by the VKA, acenocoumarol.Methods: We performed a cross-sectional study in patients undergoing VKA therapy, followed in the cardiology department of the University Hospital of Sidi Bel Abbes.Results: One hundred patients were included. We recorded 22 cases of bleeding. Overdose and concomitant use of drugs that interfere with the acenocoumarol effect are significant risk factors of bleeding.Conclusions: Knowledge of predictive factors for VKA-related excessive anticoagulation seems to be of the utmost importance for improving patient management. There is a need for a national registry to assess the efficacy and safety of drug use in the short and long term. This pilot study is a cornerstone in the development of oral anticoagulation therapy monitoring in our region.

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Section: Discussionmentioning

confidence: 71%

Frequency of bleeding complications in Algerian patients treated with the vitamin K antagonist acenocoumarol and associated factors

Belkacemi

Merad

Berber

2021

Int J Basic Clin Pharmacol

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“…The kidney is not the major site of warfarin metabolism, but the association of bleeding with warfarin therapy in patients with renal failure is well established [27]. Studies performed more than 50 years ago showed that coumarin derivatives were well tolerated by some patients with renal disease [28]. However, uremic persons often have gastrointestinal lesions, such as angiodysplasia and gastritis, making them more prone to bleeding.…”

Section: Warfarinmentioning

confidence: 99%

Pitfalls in the Use of Anticoagulants

Green

2002

Hemodialysis International

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Anticoagulants are in widespread use for the management of a variety of conditions, ranging from thrombus prevention to the treatment of arterial and venous occlusion. As with any effective therapy, recognition of adverse effects is critically important for the safe use of these drugs. Pitfalls in the use of heparins include dosing in close proximity to invasive procedures; not closely monitoring patients in whom dose adjustments may be required, such as the very obese, the elderly, and patients with renal or hepatic failure; failing to make dose adjustments during pregnancy; and not recognizing when patients are developing heparin-induced thrombocytopenia or osteoporosis. Pitfalls in the use of unfractionated heparin include delays in achieving a therapeutic activated partial thromboplastin time (aPTT) and failure to consider the effects of protein binding in acutely ill patients. A pitfall in the use of low molecular weight heparin is giving prophylactic doses when therapeutic doses are indicated. Pitfalls in the use of warfarin are stopping heparin before the warfarin is fully effective; failing to maintain the International Normalized Ratio within the therapeutic range; failing to adjust the dose of warfarin because of changes in diet, renal or hepatic failure, and exposure to new drugs; failing to stop warfarin at an appropriate interval before an invasive procedure; and giving warfarin during pregnancy. Pitfalls in the use of thrombin inhibitors include using them with thrombolytic agents; giving them in proximity to invasive procedures; not adjusting the dose for renal or hepatic failure; and failing to consider the effect of these agents on the prothrombin time when initiating warfarin therapy.

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Cardiovascular Diseases

Schaaf¹

1954

AMA Arch Intern Med

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It has been hypothesized that Helicobacter pylori (Hp) infection may contribute to reduced stature, risk of hypertension or obesity. The aim was to evaluate body indices in Hp positive and negative persons. A total of 2436 subjects (4-100 years old) were tested for Hp status by 13 C-urea breath test. Data on height and weight were collected for 84%, and blood pressure for 80% of the study subjects. The prevalence of Hp infection was 41.6%. The odds ratio for a 10-year increase in age was 1.21 (95% CI 1.17-1.25, p-value <0.001). Statistically significant negative association of Hp positivity with body height was most pronounced in the younger age groups, while a positive association of Hp positivity with body mass index was only seen in those aged 15+ years. There was a negative effect of Hp positivity on systolic and diastolic blood pressure in subjects below 25 and a relatively strong positive effect on blood pressure in subjects over 65 years. Residual confounding by social characteristics as a possible explanation for the associations of Hp positivity with height and blood pressure cannot be excluded. Unmeasured factors related to social and family environment may cause the apparent association between Hp positivity and children's growth and blood pressure.

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Use of Bishydroxycoumarin (Dicumarol®) in the Presence of Impaired Renal Function

Cited by 21 publications

References 6 publications

Frequency of bleeding complications in Algerian patients treated with the vitamin K antagonist acenocoumarol and associated factors

Frequency of bleeding complications in Algerian patients treated with the vitamin K antagonist acenocoumarol and associated factors

Pitfalls in the Use of Anticoagulants

Cardiovascular Diseases

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