Anticoagulants (Figure 4.9)

4.5
Anticoagulants (Figure 4.9)

A diagram titled, anticoagulant mechanism of action. The intrinsic and extrinsic pathways lead to rivaroxaban abixaban U F H, enoxaparin, and warfarin, The end part is labeled, thrombin and fibrinogen.

Figure 4.9

  • Consider coordinating with physician and surgeon to establish a plan regarding adjusting anticoagulants for an elective procedure, balancing the risk between re‐thrombosis and postoperative hemostasis

Direct Thrombin Inhibitors

  • Dabigatran
  • Hirudin
  • Mechanism of Action
    • Directly binds and inhibits thrombin
  • Clinical Implications
    • Local hemostasis techniques
    • Minimally invasive procedure
      • Continue drug perioperatively [23]
    • Moderate/high bleeding expected
      • Discuss with surgeon and physician
      • Consider delaying elective cases until patient no longer requires anticoagulant therapy
      • Consider heparin bridge therapy for high‐risk patients
      • Discontinuation time depends on renal function [24]
    • Reversal
      • Dabigatran
        • Idarucizumab
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Oct 16, 2024 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Anticoagulants (Figure 4.9)

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