SCR - Anticoagulants SDCEP guidance Flashcards

1
Q

Give examples of DOACs.

A
  • apixaban
  • dabigatran
  • rivaroxaban
  • edoxaban
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2
Q

Give examples of vitamin K antagonists.

A

Warfarin

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3
Q

Give examples of antiplatelet drugs.

A
  • aspirin
  • clopidogrel
  • dipyridamole
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4
Q

What is considered a high bleeding risk procedure?

A
  • complex XLA (3+ or adjacent)
  • flap raising procedures
  • gingival recontouring
  • biopsy
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5
Q

What is considered a low bleeding risk procedure?

A
  • simple XLA (<3, not adjacent)
  • incision and drainage of swelling
  • 6PPC
  • subgingival PMPR
  • restorations with subgingival margins
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6
Q

What is considered a procedure with no bleeding risk?

A
  • LA
  • BPE
  • supragingival PMPR
  • restorations with supragingival margins
  • RCT
  • impressions
  • orthodontic appliances
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7
Q

Which DOACs are taken twice daily?

A
  • apxiaban
  • dabigatran
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8
Q

Which DOACs are taken once daily?

A
  • edoxaban
  • rivaroxaban
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9
Q

What is the guidance for a low risk procedure for a patient taking apixaban?

A

Treat without interrupting medication

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10
Q

What is the guidance for a low risk procedure for a patient taking dabigatran?

A

Treat without interrupting medication

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11
Q

What is the guidance for a low risk procedure for a patient taking edoxaban?

A

Treat without interrupting medication

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12
Q

What is the guidance for a high risk procedure for a patient taking apixaban?

A

Miss morning dose

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13
Q

What is the guidance for a high risk procedure for a patient taking dabigatran?

A

Miss morning dose

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14
Q

What is the guidance for a low risk procedure for a patient taking rivaroxaban?

A

Treat without interrupting medication

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15
Q

What is the guidance for a high risk procedure for a patient taking rivaroxaban?

A

Delay morning dose, wait until 4 hours after haemostasis achieved to take dose

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16
Q

What is the guidance for a high risk procedure for a patient taking edoxaban?

A

Delay morning dose, wait until 4 hours after haemostasis achieved to take dose

17
Q

When should the INR be checked?

A
  • <24 hours ideal
  • <72 hours if patient is stable
18
Q

What is the target range for the INR?

A

2-4

19
Q

What INR score indicates it is safe to treat patients?

A

<4

20
Q

What is the advice for patients taking aspirin alone?

A

Treat without interrupting medication

21
Q

What is the advice for patients taking aspirin in combination with another antiplatelet?

A

Treat without interrupting medication

22
Q

What is the advice for patients taking clopidogrel?

A

Treat without interrupting medication

23
Q

What is the advice for patients taking dipyridamole?

A

Treat without interrupting medication

24
Q

What is the advice for patients taking antiplatelet and anticoagulant medication?

A

Consult prescribing clinician

25
Q

What medical conditions are associated with increased bleeding risk?

A
  • chronic renal failure
  • heart failure
  • liver disease
  • haematological malignancy
  • recent radio/chemotherapy
  • coagulation disorders
  • CTD
26
Q

What is the mode of action of warfarin?

A

Vitamin K antagonist

27
Q

What is the mode of action of apixaban?

A

Factor 10a inhibitor

28
Q

What is the mode of action of edoxaban?

A

Factor 10a inhibitor

29
Q

What is the mode of action of rivaroxaban?

A

Factor 10a inhibitor

30
Q

What is the mode of action of dabigatran?

A

Direct thrombin inhibitor (factor 11a)

31
Q

What is the mode of action of aspirin?

A

COX-I and COX-II inhibitor