Dentistry of users of novel anticoagulants
This article, it is explained novel anticoagulant drugs the dentistry of patients using these drugs, and the risk of bleeding. The INR test is not suitable for evaluating the coagulation levels of patients who take Dabigatran, Apixaban, or Rivaroxaban. The effects of Dabigatran on coagulation can be qualitatively evaluated by APTT (activated partial thromboplastin time).
Similarly, the PT (prothrombin time) test can show some changes in anticoagulant levels with Rivaroxaban. Although quantitatively, appropriate laboratory tests for new anticoagulants are not yet widely available, because these drugs have more predictable anticoagulant levels and less important monitoring than warfarin, (these tests) are routinely performed. can’t
The characteristics of these drugs
Compared to warfarin, the newer anticoagulants show a faster onset of action (2-4 hours) and relatively shorter half-lives (5-13 hours for rivaroxaban (Zalerban), about 12 hours for apixaban, and about 13 hours for dabigatran, due to these pharmacologic characteristics, changing the anticoagulant status of a person too rapidly may reduce the threshold of anticoagulant activity below the therapeutically desirable point. However, for the newer anticoagulants, reversal agents are not yet available. Similar to the previous case, the relatively short half-life of these drugs allows the rapid reduction of the anticoagulant effects of this drug.
daily consumption
Apixaban (eliquis) and dabigatran (paradaxa) are taken twice a day, while rivaroxaban (Xarelto) is commonly taken once a day, in the morning or at night. For each of these drugs, a lower dose is used in patients, including patients with different levels of kidney damage, and elderly patients. Patients with acute deep vein thrombosis and acute pulmonary embolism may use high doses of apixaban or rivaroxaban in the first 1 to 3 weeks of their treatment.
