Pristup kod pacijenta s poremećajem krvarenja u dentalnoj medicini

master's thesis

• Title (english): Treatment approach in a patient with bleeding disorder in dental medicine
• Author: Karmen Petrić
• Mentor: Marko Granić (mentor)
• Committee member: Marko Granić (predsjednik povjerenstva)
• Committee member: Tomislav Škrinjarić (član povjerenstva)
• Committee member: Tomislav Katanec (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2022-06-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Sve veći broj pacijenta koji se liječe u ordinaciji dentalne medicine svakodnevno uzima
antikoagulacijsku ili antiagregacijsku terapiju. Ovi lijekovi se propisuju kod kardiovaskularnih
bolesti te ti pacijenti spadaju u rizičnu skupinu za razne stomatološke zahvate.
Antikoagulacijski lijekovi koje koristi najveći dio pacijenata su varfarinska skupina i novi
antikoagulacijski lijekovi (NOAK), koje čine dabigatran, apiksaban i rivaroksaban. Varfarin
inhibira sintezu faktora zgrušavanja koji su ovisni o djelovanju vitamina K. Dabigatran inhibira
trombin, dok apiksaban i rivaroksaban inhibiraju faktor Xa. U antiagregacijskoj terapiji
najkorišteniji su acetilsalicilna kiselina, koja inhibira sintezu tromboksana A2, i k lopidogrel, koji
inhibira agregaciju trombocita preko posrednika adenozin difosfata. Antikoagulacijski i
antiagregacijski lijekovi, osim što sprječavaju tromboembolijske događaje, produljuju vrijeme
krvarenja. Pacijenti na takvoj terapiji svakodnevno se susreću u ordinaciji dentalne medicine te je
njihovom liječenju, posebice zahvatima kod kojih dolazi do pojačanog krvarenja, potrebno
pristupiti s oprezom zbog mogućih komplikacija produljenog postoperativnog krvarenja.

Abstract (english)

More and more patients treated in dental offices are taking daily anticoagulant or antiplat elet
therapy. These drugs are prescribed for cardiovascular diseases, and these patients belong to the
risk group for various dental procedures.
The anticoagulants taken by most patients belong to the warfarin group and the new anticoagulants
(NOAC), which include dabigatran, apixaban, and rivaroxaban. Warfarin inhibits the synthesis of
clotting factors that are dependent on the action of vitamin K. Dabigatran inhibits thrombin, while
apixaban and rivaroxaban inhibit factor Xa. For antiplatelet therapy, acetylsalicylic acid, which
inhibits thromboxane A2 synthesis, and clopidogrel, which inhibits platelet aggregation via
adenosine diphosphate mediators, are the most commonly used drugs. Anticoagulant and
antiplatelet drugs not only prevent thromboembolic events but also prolong bleeding time. Patients
receiving such therapy are encountered daily in dental practice, and caution should be exercised in
their treatment, especially during procedures involving increased bleeding, because of possible
complications from prolonged postoperative bleeding.

• Keywords: stomatologija; antikoagulanti; krvarenje
• Keywords (english): Dentistry; Anticoagulants; Hemorrhage
• Language: croatian
• URN:NBN: urn:nbn:hr:127:524611
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-10-19 12:31:07