Antikoagülan ve Antiagregan İlaç Kullanan Hastaları Hangi Parametrelerle Takip Ediyoruz?
Özet
Antikoagülan ve antiagregan ilaç kullanan ve cerrahi işlem geçirmesi gereken hasta sayılarının giderek artmaktadır. Antikoagülan ve antiagregan ilaçlar, trombosit aktivasyonu ve koagülasyonun çeşitli basamakları inhibe eden ilaçlardır. Elimizde, bu hastalarda en uygun yaklaşımın ne olduğu ile ilişkili, başka amaçlarla tasarlanmış çalışmaların alt grup incelemelerinden elde edilmiş veriler bulunmaktadır. Bu ilaçların invaziv prosedürlerden önce kesilmesinin neden olduğu risk ile kanama riski arasındaki dengeyi sağlamak zor olmakla beraber bu hastaların perioperatif dönemde hangi parametreler kullanılarak izleneceği önem kazanmaktadır.
The number of patients using anticoagulant and antiplatelet drugs and requiring surgical procedures is increasing. Anticoagulant and antiplatelet drugs are medications that inhibit various steps of platelet activation and coagulation. We have data from subgroup studies designed for other purposes regarding the most appropriate approach for these patients. It is difficult to balance the risk of bleeding with the risk of stopping these drugs before invasive procedures, and the parameters that will be used to monitor these patients in the perioperative period are important.
Referanslar
Ghantous AE, Ferneini EM. Aspirin, Plavix and Other Antiplatelet Medications What the Oral and Maxillofacial Surgeon Needs to Know. Oral Maxillofacial Surg Clin N Am 2016; 28: 497-506.
Kayaalp SO. Rasyonel Tedavi Yönünden Tıbbi Farmakoloji. 10.Baskı, Ankara, Feryal Matbaacılık, 2002.
Gurbel PA, Tantry US. Combination antithrombotic therapies. Circulation. 2010;121:569–83.
Michelson AD. Methods for the measurement of platelet function. Am J Cardiol. 2009; 103(3 Suppl):20A-26A.
Frelinger AL, Li Y, Linden MD, et al. Aspirin ‘resistance’: role of pre-existent platelet reactivity and correlation between tests. J Thromb Haemost. 2008;6(12):2035-2044.
Lordkipanidz´e M, Pharand C, Schampaert E, Turgeon J, Palisaitis DA, Diodati JG. A comparison of six major platelet function tests to determine the prevalence of aspirin resistance in patients with stable coronary artery disease. Eur Heart J. 2007;28(14):1702-1708.
Santilli F, Rocca B, De Cristofaro R, et al. Platelet cyclooxygenase inhibition by low-dose aspirin is not reflected consistently by platelet function assays: implications for aspirin “resistance.” J Am Coll Cardiol. 2009;53(8):667-677.
Michelson AD. Methods for the measurement of platelet function. Am J Cardiol. 2009; 103(3 Suppl):20A-26A.
Frelinger AL III, Bhatt DL, Lee RD, et al. Clopidogrel pharmacokinetics and pharmacodynamics vary widely despite exclusion or control of polymorphisms (CYP2C19, ABCB1, PON1), noncompliance, diet, smoking, comedications (including proton pump inhibitors), and pre-existent variability in platelet function.J Am Coll Cardiol. 2013;61(8):872-879.
Lordkipanidz´e M, Pharand C, Nguyen TA, Schampaert E, Palisaitis DA, Diodati JG. Comparison of four tests to assess inhibition of platelet function by clopidogrel in stable coronary artery disease patients. Eur Heart J. 2008;29(23): 2877-2885.
Shuldiner AR, O’Connell JR, Bliden KP, et al. Association of cytochrome P450 2C19 genotype with the antiplatelet effect and clinical efficacy of clopidogrel therapy. JAMA. 2009;302(8):849-857.
Mega JL, Close SL, Wiviott SD, et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med. 2009;360(4):354-362.
Garcia DA et al. American College of Chest Physicians. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis. 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e24S-43S.
Tran H et al. New oral anticoagulants: a practical guide on prescription, laboratory testing and peri-procedural/bleeding management. IMJ 2014; 44: 525-36.
Rosencher N, Bonnet MP, Sessler DI. Selected new antithrombotic agents and neuraxial anaesthesia for major orthopaedic surgery: management strategies. Anaesthesia 2007;62:1154- 60.
Referanslar
Ghantous AE, Ferneini EM. Aspirin, Plavix and Other Antiplatelet Medications What the Oral and Maxillofacial Surgeon Needs to Know. Oral Maxillofacial Surg Clin N Am 2016; 28: 497-506.
Kayaalp SO. Rasyonel Tedavi Yönünden Tıbbi Farmakoloji. 10.Baskı, Ankara, Feryal Matbaacılık, 2002.
Gurbel PA, Tantry US. Combination antithrombotic therapies. Circulation. 2010;121:569–83.
Michelson AD. Methods for the measurement of platelet function. Am J Cardiol. 2009; 103(3 Suppl):20A-26A.
Frelinger AL, Li Y, Linden MD, et al. Aspirin ‘resistance’: role of pre-existent platelet reactivity and correlation between tests. J Thromb Haemost. 2008;6(12):2035-2044.
Lordkipanidz´e M, Pharand C, Schampaert E, Turgeon J, Palisaitis DA, Diodati JG. A comparison of six major platelet function tests to determine the prevalence of aspirin resistance in patients with stable coronary artery disease. Eur Heart J. 2007;28(14):1702-1708.
Santilli F, Rocca B, De Cristofaro R, et al. Platelet cyclooxygenase inhibition by low-dose aspirin is not reflected consistently by platelet function assays: implications for aspirin “resistance.” J Am Coll Cardiol. 2009;53(8):667-677.
Michelson AD. Methods for the measurement of platelet function. Am J Cardiol. 2009; 103(3 Suppl):20A-26A.
Frelinger AL III, Bhatt DL, Lee RD, et al. Clopidogrel pharmacokinetics and pharmacodynamics vary widely despite exclusion or control of polymorphisms (CYP2C19, ABCB1, PON1), noncompliance, diet, smoking, comedications (including proton pump inhibitors), and pre-existent variability in platelet function.J Am Coll Cardiol. 2013;61(8):872-879.
Lordkipanidz´e M, Pharand C, Nguyen TA, Schampaert E, Palisaitis DA, Diodati JG. Comparison of four tests to assess inhibition of platelet function by clopidogrel in stable coronary artery disease patients. Eur Heart J. 2008;29(23): 2877-2885.
Shuldiner AR, O’Connell JR, Bliden KP, et al. Association of cytochrome P450 2C19 genotype with the antiplatelet effect and clinical efficacy of clopidogrel therapy. JAMA. 2009;302(8):849-857.
Mega JL, Close SL, Wiviott SD, et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med. 2009;360(4):354-362.
Garcia DA et al. American College of Chest Physicians. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis. 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e24S-43S.
Tran H et al. New oral anticoagulants: a practical guide on prescription, laboratory testing and peri-procedural/bleeding management. IMJ 2014; 44: 525-36.
Rosencher N, Bonnet MP, Sessler DI. Selected new antithrombotic agents and neuraxial anaesthesia for major orthopaedic surgery: management strategies. Anaesthesia 2007;62:1154- 60.
