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Anticoagulant


Presentation

  • The most common presentation of long-acting anticoagulant rodenticide poisoning is mucocutaneous bleeding, with other common presentations including haematuria, gingival bleeding, epistaxis and gastrointestinal bleeding.[ncbi.nlm.nih.gov]
Fatigue
  • Symptoms of Heart Disease Heart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs...[medicinenet.com]
Nausea
  • The patient was admitted with intense abdominal pain, nausea, vomiting, and a total obstruction of duodenum. After a diagnosis of intramural hematoma, a good prognosis was achieved with conservative care.[ncbi.nlm.nih.gov]
  • The more common side effects that have been associated with anticoagulants include: Bleeding Gastrointestinal effects such as diarrhea, heartburn, nausea, and loss of appetite Irritation and pain around the site of injection (injectable anticoagulants[drugs.com]
  • Symptoms of Heart Disease Heart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs...[medicinenet.com]
  • […] idarucizumab administration were in patients who did not restart anticoagulation. 40 The half-life of idarucizumab is 45 minutes; if needed, anticoagulation can be restarted within 24 hours. 39 Hypersensitivity reactions such as rash, urticaria, hypotension, nausea[powerpak.com]
Abdominal Pain
  • The patient was admitted with intense abdominal pain, nausea, vomiting, and a total obstruction of duodenum. After a diagnosis of intramural hematoma, a good prognosis was achieved with conservative care.[ncbi.nlm.nih.gov]
Melena
  • The patient was admitted in hospital as she presented with gastrointestinal bleeding (melena), asthenia and progressive anemia.[ncbi.nlm.nih.gov]
Bleeding Gums
  • Excessive bleeding Signs of excessive bleeding can include: passing blood in your pee passing blood when you poo or having black poo severe bruising prolonged nosebleeds (lasting longer than 10 minutes) bleeding gums vomiting blood or coughing up blood[nhs.uk]
  • gums Purple coloring to your fingers or toes Again, tell your doctor right away if you have any of these side effects.[texasheart.org]
  • Bleeding gums, excessive bruising, nosebleeds, heavy menstrual bleeding, and prolonged bleeding from cuts may indicate an overdosing of medication. Notify your doctor if these problems occur.[hopkinslupus.org]
Oral Bleeding
  • Q: At what point do I seek help for oral bleeding and whom should I contact? A: If at any time you have a concern regarding bleeding after surgery, you should feel free to contact your dentist or oral surgeon.[aaom.com]
Epistaxis
  • The most common presentation of long-acting anticoagulant rodenticide poisoning is mucocutaneous bleeding, with other common presentations including haematuria, gingival bleeding, epistaxis and gastrointestinal bleeding.[ncbi.nlm.nih.gov]
  • INR range 2.0 to 3.0, 29% below 2.0, 11% within 3.1 to Major Hemorrhage During the first year, 26 patients sustained a major hemorrhage (9 intracranial, 11 gastrointestinal, 1 retroperitoneal, 1 hemothorax after a fall, 1 ocular, 1 hemarthrosis, and 2 epistaxis[doi.org]
Hematuria
  • No patients in any of the groups experienced cardiovascular events during their hospital stay or required rehospitalization for hematuria after discharge.[ncbi.nlm.nih.gov]

Workup

  • Hereditary and Acquired Hypercoagulability Workup. Medscape Hematology. Available online at . Accessed on 8/05/18. Krautscheid, P. et. al. (2018 August, Updated). Hypercoagulable States – Thrombophilia. ARUP Consult. Available online at .[labtestsonline.org]
Pericardial Effusion
  • A key result of the PREVAIL trial was that pericardial effusions requiring intervention occurred at a rate comparable to other left atrial procedures.[dicardiology.com]
  • Hemophilia or another bleeding disorder Are pregnant High risk of bleeding in the brain (hemorrhagic stroke) Cerebral aneurysm Dissecting aorta Pericarditis Pericardial effusion Bacterial endocarditis Active ulceration An active bleed Are undergoing surgery[medicinenet.com]
Cytopenia
  • Paroxysmal nocturnal haemoglobinuria (PNH) is a rare acquired disorder of haematopoietic stem cells characterized by intravascular haemolysis, cytopenias and thrombophilia. Thrombophilia is the leading cause of mortality in patients with PNH.[ncbi.nlm.nih.gov]

Treatment

  • Elevated INR values due to VKA treatment could be reversed (INR 1.5) in 63.1% (95% CI: 61.0-65.2) of study subjects after treatment with 4F-PCC, as compared with 12.2% (95% CI: 8.2-16.2) after treatment with fresh frozen plasma (FFP), (p CONCLUSIONS:[ncbi.nlm.nih.gov]
  • The lack of data with regards to bleeding risk in dental treatment is still a concern among clinicians.[doi.org]

Prognosis

  • After a diagnosis of intramural hematoma, a good prognosis was achieved with conservative care.[ncbi.nlm.nih.gov]
  • ‘Patients with a poor short-term prognosis, those with contraindications to aspirin and those taking anticoagulants or anti-inflammatory agents were excluded from the study.’[en.oxforddictionaries.com]
  • Adverse prognosis of incidentally detected ambulatory atrial fibrillation: a cohort study. Thromb Haemost . 2014;112(2):276-286. PubMed Google Scholar Crossref 4. Fine JP, Gray RJ.[jamanetwork.com]
  • […] that the recommendations set forth are too exhaustive, with no clear benefits demonstrated in randomized clinical trials for each specific scenario, 14 and that the guidelines have been established without conclusive data supporting improved patient prognosis[revespcardiol.org]

Etiology

  • Unstable angina: an etiologic approach to management. Circulation 1998;98(21):2219-22. PMID: 9826306. DeWood MA, Stifter WF, Simpson CS, et al. Coronary arteriographic findings soon after non-Q-wave myocardial infarction.[effectivehealthcare.ahrq.gov]
  • ELEVATED INR IN THE ABSENCE OF BLEEDING The 2012 ACCP Chest Guideline and 2015 Anticoagulation (AC) Forum recommendations for managing elevated INRs in the absence of bleeding are described in Table 1. 24,25 Patients should be interviewed to identify etiologies[powerpak.com]

Epidemiology

  • An in-depth analysis of the ACS therapeutic area and an epidemiology driven sales forecast models are presented in Decision Resources’ ACS Pharmacor.[web.archive.org]
  • Epidemiological profile of atrial fibrillation: a contemporary perspective.. Prog Cardiovasc Dis., 48 (2005), pp. 1-8 [3] Marinigh R, Lip GY, Fiotti N, Giansante C, Lane DA..[revespcardiol.org]
  • , Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA 3 Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Both disease states have thrombosis as a core pathophysiologic process which requires treatment - low sheer stress thrombi in AF and intracoronary high sheer stress thrombi in PCI.[ncbi.nlm.nih.gov]
  • Patients can develop independent indications for antiplatelet and oral anticoagulant therapy, but in most cases the pathophysiology will intersect.[bmj.com]
  • […] this antibody was first demonstrated in 1952 by Conley and Hartmann when they observed prolongation of lipid dependent coagulation tests in patients with systemic lupus erythematosus (SLE). [11] For a lack of a better understanding of the underlying pathophysiology[emedicine.medscape.com]
  • Zacconi Related Book First chapter Pathophysiology of Atherothrombosis — Thrombus Growth, Vascular Thrombogenicity, and Plaque Metabolism By Atsushi Yamashita and Yujiro Asada We are IntechOpen, the world's leading publisher of Open Access books.[intechopen.com]

Prevention

  • CONCLUSION: Findings from this overview support the superiority of NOACs and patient's self-management for preventing stroke in AF patients.[ncbi.nlm.nih.gov]
  • The NOACs directly inhibit one specific coagulation factor in the cascade, whereas warfarin prevents the coagulation process by suppressing the synthesis of several vitamin K-dependent coagulation factors.[pharmaceutical-journal.com]

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