Antithrombotic medication

A contact dermatitis occurs infrequently. Because feverfew also inhibits human blood platelet aggregation, interactions are possible with antithrombotic medications such as aspirin or warfarin (Groenewegen and Heptinstall 1990). Abrupt discontinuation of feverfew by people taking it chronically for treatment of migraine can produce rebound withdrawal symptoms. These consist of migraines, anxiety, poor sleep patterns, and stiffness of the muscles and joints. 

A female patient with a mechanical heart valve who is taking warfarin informs you that she hopes to get pregnant in the near future. What advice do you give her regarding her antithrombotic medication during the anticipated pregnancy ... 

Patients who have had a stroke or transitory ischemic attack associated with intracranial artery stenosis (>50%) have a 12-14% risk of subsequent stroke in the 2-year period after the initial event, regardless of treatment with antithrombotic medications. Atherosclerosis in the intracranial portion of the ICA and the MCA is more common in the African-American, Hispanic, and Asian populations for unknown reasons. The proportion of patients hospitalized for ischemic strokes with symptomatic intracranial stenosis ranges from 1% in non-Hispanic whites to as high as 50% in Asian populations [21, 22]. Atherosclerosis in the intracranial portion of the carotid and in the MCA often causes multiple strokes in the same vascular territory. It may also cause slow stroke syndrome, in which there is progressive worsening of focal cortical ischemic symptoms over days or weeks. In addition, the penetrator arteries flowing to the deep white matter and striatum originate from the MCA stem (Ml) and may be occluded in patients with severe MCA stenosis [20]. 

Whether there is a history of previous seizure, diabetes, warfarin or antithrombotic medication ( blood thinners ) use, prior stroke or hemorrhage, prior transient ischemic attack (TIA), prior myocardial infarction (MI), drug abuse, trauma, head or neck pain. 

Fang, M.C., Stafford, R.S., Ruskin, J.N., Singer, D.E. (2004). National Trends In Antiarrhythmic And Antithrombotic Medication Use In Atrial Fibrillation. Arch Intern Med, Vol.164, pp 55-60, ISSN 1538-3679... 

After vascular access surgery, benefits and risks of antithrombotic medications should be considered. The aim of such treatment is increasing the access duration, but its suitability for needling is also an important outcome to be considered. 

In patients with NSTE ACS scheduled for early PCI, administration of either abciximab or eptifibatide (double bolus) is recommended. The use of tirofiban in these patients is not recommended, because it has been shown to be inferior to abciximab.2 Medical therapy with glycoprotein Ilb/IIIa receptor inhibitors in patients not undergoing PCI is reserved for higher-risk patients, such as those with positive troponin or ST-segment depression, and patients who have continued or recurrent ischemia despite other antithrombotic therapy.2... 

Given that VTE can be debilitating or fatal, it is important to treat it quickly and aggressively.8 On the other hand, because major bleeding induced by antithrombotic drugs can be equally harmful, it is important to avoid treatment when the diagnosis is not reasonably certain. Assessment of the patient s status should focus on the search for risk factors in the patient s medical history... 

Prophylaxis should be continued throughout the period of risk. For general surgical procedures and medical conditions, prophylaxis can be discontinued once the patient is able to ambulate regularly and other risk factors are no longer present. Most clinical trials support the use of antithrombotic therapy for 21 to 35 days after total hip replacement and hip fracture repair surgeries. 

In preparation for chest discomfort during alcohol injection, prophylactic analgesic medication (eg. fentanyl 25 mm IV) is administered. Antithrombotic prophylaxis with intravenous, weight-adjusted heparin is given to maintain an activated clotting time of 200 to 250 seconds. 

Antithrombotic Trialists Collaboration (2002). Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. British Medical Journal 324 71-86... 

Colin Baigent is a UK Medical Research Coimcil Scientist and coordinator of the Antithrombotic Trialists Collaboration. His interests include the treatment and prevention of cardiovascular disease and the causes of such disease in chronic renal failure. 

Note that antithrombin does not mean the same thing as antithrombotic agent (though it is used in this wider sense in some medical databases). 

It may be noted that some medical databases refer to antithrombotic agents as ANTITHROMBINS. This is not an exact use of the term as antithrombins, mechanistically, are a subtype of anticoagulants. 

There are many pediatric medical, nursing, and pharmacy journals that include articles on pediatric drug therapies (Table 2). Pediatrics, the journal of the American Academy of Pediatrics (AAP), and the Journal of Pediatrics are considered by most pediatric practitioners to be the top in the field. Pediatrics is of particular use to clinicians because it includes the policy statements developed by the AAP. These statements are considered to represent standards of practice by pediatricians. Many of these statements are also of interest to clinical pharmacists, such as the yearly schedule for routine childhood immunizations. Other AAP policy statements of note include recommendations on the administration of medications during breastfeeding, the ethical treatment of children enrolled in clinical research trials,and methods to reduce medication errors in the pediatric inpatient setting. The Journal of Pediatrics has also published useful practice recommendations, such as the guidelines for antithrombotic therapy.The pediatric journal for the American Medical Association, Archives of Pediatrics and Adolescent Medicine, often contains large-scale sur-... 

The treatment of patients with symptomatic intracranial atherosclerotic disease can be summarized into prevention of occurrence of intraluminal thrombosis, plaque stabilization, and control of risk factors for atherosclerosis. Anticoagulation (compared with aspirin) has not shown to be beneficial in patients with intracranial atherosclerotic disease [24]. Current guidelines recommend that aspirin alone, the combination of aspirin and extended release dipyridamole, and clopidogrel monotherapy (rather than oral anticoagulants) are aU acceptable options [24]. hi patients with hemodynamically sigifificant intracranial stenosis who have symptoms despite medical therapies (antithrombotics, statins, and other treatments for risk factors), the usefulness of endovascular therapy (angioplasty and/or stent placement) is uncertain and is considered investigational [22, 25],... 

Dextran is generally used for medical purposes as an antithrombotic (antiplatelet), to reduce blood viscosity, and as a volume expander in anemia. " It has been found out that dextran can be degraded by the enzyme dextranase in the colon, and so a polymeric prodrug for colonic drug delivery based on dextran can be possibly designed. 

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