Antikoagulacijska terapija i invazivni dentalni postupci

master's thesis

• Title (english): Anticoagulation therapy and invasive dental procedures
• Author: Katja Karba
• Mentor: Jasminka Peršec (mentor)
• Committee member: Jasminka Peršec (predsjednik povjerenstva)
• Committee member: Davor Brajdić (član povjerenstva)
• Committee member: Josip Biočić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); (Chair of Anaesthesiology and Reanimatology); Zagreb
• Defense date and country: 2020-09-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Antikoagulantni lijekovi izravno ili neizravno sprječavaju stvaranje ugrušaka u krvnim žilama
u svrhu održavanja normalnog protoka krvi. Mogu se primjenjivati parenteralno u obliku
injekcija ili peroralno u obliku tableta. Najčešće su korišteni parenteralni antikoagulansi
nefrakcionirani heparin i niskomolekularni heparin. U oralne antikoagulanse ubrajaju se
inhibitori vitamina K i novi izravni antikoagulantni lijekovi (NOAK). Kod pacijenata na
antikoagulantnoj terapiji liječnik dentalne medicine mora pratiti smjernice i protokole
provođenja invazivnih dentalnih postupaka. U slučaju invazivnog zahvata kod pacijenata koji
uzimaju heparin potrebno se konzultirati s pacijentovim liječnikom koji je ordinirao terapiju.
Smjernice kod pacijenata na terapiji antagonistima vitamina K preporučuju provođenje zahvata
brez prekidanja terapije ako je INR između 2 i 3,5 uz primjenu lokalnih mjera hemostaze. Novi
antikoagulantni lijekovi relativno su kratko na tržištu te još ne postoje strogo definirani
protokoli u slučaju invazivnih dentalnih zahvata. Kod pacijenata na NOAK, kojima je potreban
zahvat normalnog ili niskog rizika krvarenja, savjetuje se nastavak terapije uz osiguravanje
lokalnih hemostatskih mjera. Kod velikih oralno kirurških operacija pacijenata na terapiji
novim antikoagulansima te većeg rizika krvarenja potrebno je konzultirati se s pacijentovim
liječnikom odgovornim za terapiju.

Abstract (english)

Anticoagulant drugs directly or indirectly prevent the formation of clots in blood vessels in
order to maintain normal blood flow. They can be applied parenterally in the form of injections
or perorally in the form of pills. Most commonly used parenteral anticoagulants are
unfractioned heparin and low-molecular-weight heparin. Oral anticoagulants also include
vitamin K inhibitors and new direct anticoagulants (NOAC). When treating patients on
anticoagulant therapy the dentist must follow the guidelines and protocols for performing
invasive dental procedures. In the case of invasive procedure on patients taking heparin, it is
necessary to consult with the patient’s doctor. It is not recommended to stop the therapy with
patients on vitamin K antagonists if the INR is between 2 and 3.5, with the use of local
hemostatic measures. The new anticoagulant drugs have been on the market for a short period
of time and there are no firmly defined protocols with invasive dental procedures. Patients on
NOAC who require a procedure with an average or low risk of bleeding are advised to continue
the therapy with the use of local hemostatic measures. When patients undergo a major oral
surgery with a higher risk of bleeding, it is necessary to consult with the patient’s doctor who
administered the therapy.

• Keywords: antikoagulansi; stomatologija; hemostaza
• Keywords (english): Anticoagulants; Dentistry; Hemostasis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:877794
• 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: Access restricted to students and staff of home institution
• Created on: 2021-01-19 11:56:10