title: The impact of Prasugrel, a new anti-platelet agent, on dental care of patients.
abstract: With increasing usage of Prasugrel (Effient), a new and highly efficient antiplatelet agent, in the management of cardiovascular events, the potential for bleeding complications has also increased. This is further compounded by the lack of a reversal agent, therefore poses a problem for clinicians engaged in oral invasive procedures. A case in which a patient taking daily Prasugrel suffered significantly prolonged bleeding following dental cleaning is reported. Local measures were used to achieve hemostasis. It is prudent to consult the prescribing physician about the risk of Prasugrel-induced bleeding, the potential for recurrence of cardiovascular events with disruption of medication, and the appropriate management strategy in advance of planned oral invasive procedures. Local measures are the first line of approach for management of hemostatic complications associated with Prasugrel, and patients should be referred to specialized centers if local approach fails. As more data become available, further evidence-based guidelines can be established.
authors.affiliation: New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA.
authors.forename: Limei
authors.initials: L
authors.lastname: Lin
authors.forename: Sami Ii
authors.initials: SI
authors.lastname: Nizam
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Fatahzadeh
mesh_terms: D002318:Cardiovascular Diseases / Q000188:drug therapy; D003777:Dental Prophylaxis / Q000009:adverse effects*; D005884:Gingival Hemorrhage / Q000139:chemically induced*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D000068799:Prasugrel Hydrochloride; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects*; D013876:Thiophenes / Q000009:adverse effects*
chemical_list: D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D013876:Thiophenes; D000068799:Prasugrel Hydrochloride