New oral anticoagulants and their implications for dental patients

Hdl Handle:
http://hdl.handle.net/10147/321849
Title:
New oral anticoagulants and their implications for dental patients
Authors:
O’Connell, John Edward
Publisher:
Jounral of the Irish Dental Association
Journal:
Jounral of the Irish Dental Association
Issue Date:
Jun-2014
URI:
http://hdl.handle.net/10147/321849
Abstract:
Anticoagulation therapy is used in several conditions to prevent or treat thromboembolism. Over the last 40 years, warfarin has been the oral anticoagulant of choice and has been considered the mainstay of treatment. However, its use is limited by a narrow therapeutic index and complex pharmacodynamics, necessitating regular monitoring and dose adjustments. Recently, two new oral anticoagulants - dabigatran etexilate (a direct thrombin inhibitor) and rivaroxiban (a factor Xa inhibitor) - have been approved for use in North America and Europe. Unlike warfarin, dabigatran and rivaroxiban are relatively small molecules that work as anticoagulants by targeting specific single steps of the coagulation cascade. Their advantages, relative to warfarin, include: predictable pharmacokinetics; limited food and drug interactions; rapid onset of action; and, short half-life. They require no monitoring. However, they lack a specific reversal agent. The number of patients taking dabigatran and rivaroxaban is increasing. Therefore, it is inevitable that dentists will be required to perform invasive procedures on this cohort of patients. This paper outlines the various properties of the new oral anticoagulants and the most recent guidelines regarding the management of these dental patients taking these medications.
Item Type:
Article
Language:
en

Full metadata record

DC FieldValue Language
dc.contributor.authorO’Connell, John Edwarden_GB
dc.date.accessioned2014-06-18T14:46:54Z-
dc.date.available2014-06-18T14:46:54Z-
dc.date.issued2014-06-
dc.identifier.urihttp://hdl.handle.net/10147/321849-
dc.description.abstractAnticoagulation therapy is used in several conditions to prevent or treat thromboembolism. Over the last 40 years, warfarin has been the oral anticoagulant of choice and has been considered the mainstay of treatment. However, its use is limited by a narrow therapeutic index and complex pharmacodynamics, necessitating regular monitoring and dose adjustments. Recently, two new oral anticoagulants - dabigatran etexilate (a direct thrombin inhibitor) and rivaroxiban (a factor Xa inhibitor) - have been approved for use in North America and Europe. Unlike warfarin, dabigatran and rivaroxiban are relatively small molecules that work as anticoagulants by targeting specific single steps of the coagulation cascade. Their advantages, relative to warfarin, include: predictable pharmacokinetics; limited food and drug interactions; rapid onset of action; and, short half-life. They require no monitoring. However, they lack a specific reversal agent. The number of patients taking dabigatran and rivaroxaban is increasing. Therefore, it is inevitable that dentists will be required to perform invasive procedures on this cohort of patients. This paper outlines the various properties of the new oral anticoagulants and the most recent guidelines regarding the management of these dental patients taking these medications.en_GB
dc.language.isoenen
dc.publisherJounral of the Irish Dental Associationen_GB
dc.titleNew oral anticoagulants and their implications for dental patientsen_GB
dc.typeArticleen
dc.identifier.journalJounral of the Irish Dental Associationen_GB
dc.description.fundingNo fundingen
dc.description.provinceMunsteren
dc.description.peer-reviewpeer-reviewen
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