Items in FPM with MESH term: Anticoagulants
Oral Anticoagulants vs. Antiplatelet Therapy - Cochrane for Clinicians
Heparins for Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction - Cochrane for Clinicians
NSAID Prescribing Precautions - Article
ABSTRACT: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding associated with NSAIDs are at especially high risk. Although aspirin is cardioprotective, other NSAIDs can worsen congestive heart failure, can increase blood pressure, and are related to adverse cardiovascular events, such as myocardial infarction and ischemia. Cyclooxygenase-2 inhibitors have been associated with increased risk of myocardial infarction; however, the only cyclooxygenase-2 inhibitor still available in the United States, celecoxib, seems to be safer in this regard. Hepatic damage from NSAIDs is rare, but these medications should not be used in persons with cirrhotic liver diseases because bleeding problems and renal failure are more likely. Care should be used when prescribing NSAIDs in persons taking anticoagulants and in those with platelet dysfunction, as well as immediately before surgery. Potential central nervous system effects include aseptic meningitis, psychosis, and tinnitus. Asthma may be induced or exacerbated by NSAIDs. Although most NSAIDs are likely safe in pregnancy, they should be avoided in the last six to eight weeks of pregnancy to prevent prolonged gestation from inhibition of prostaglandin synthesis, premature closure of the ductus arteriosus, and maternal and fetal complications from antiplatelet activity. Ibuprofen, indomethacin, and naproxen are safe in breastfeeding women. Care should be taken to prevent accidental NSAID overdose in children by educating parents about correct dosing and storage in childproof containers.
ABSTRACT: Many physicians and other providers attempt therapeutic warfarin oversight without regularly scheduled anticoagulation appointments. Studies show that the risk of major bleeding or thromboembolic events due to warfarin therapy is between 2 percent and 12 percent per year. Point-of-care anticoagulation devices are convenient for patients and physicians and allow for patient-focused anticoagulation care.
A Systematic Approach to Managing Warfarin Doses - Improving Patient Care
Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane for Clinicians
Thromboembolism - Clinical Evidence Handbook
Does Long-Term Anticoagulation Improve Function After Stroke? - Cochrane for Clinicians