Managing patients on warfarin therapy: a case report.
Coagulotherapy is a common therapeutic regimen most frequently utilizing warfarin. This therapy may have important dental ramifications. An understanding of the mechanisms of action and drug interactions may help avoid problems. Questions commonly arise as to what dental procedures may be safely considered when a patient is on anticoagulant therapy. The coagutherapy level is measured in values of the International Normalized Ratio (INR). Any question about the appropriateness of dental procedures should be referred to the physician prescriber of the anticoagulant therapy. Generally, controlling bleeding is less of a problem than the management of thrombi and vascular occlusion from decreased coagutherapy. A case is presented in which the INR reached a critical value as the result of drug interactions and miscommunication.
Aldous
J A
JA
Department of Surgery, BC 101 School of Medicine, University of Utah, Salt Lake City, Utah 84132, USA. jay.aldous@hsc.utah.edu
Olson
C J
CJ
D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects*; D002981:Clindamycin / Q000009:adverse effects; D004347:Drug Interactions; D004357:Drug Synergism; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000209:etiology*; D013165:Splints; D013917:Thrombin / Q000627:therapeutic use; D014014:Tissue Adhesives / Q000627:therapeutic use; D014081:Tooth Extraction; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D006490:Hemostatics; D014014:Tissue Adhesives; D014812:Vitamin K; D002981:Clindamycin; D014859:Warfarin; D006493:Heparin; D013917:Thrombin