scholarly journals Surgical procedures in patients on aspirin. Literature Review

Author(s):  
Stella Papamimikou ◽  
◽  
Nikolaos Kolomvos ◽  
Nadia Theologie-Lygidakis

Aspirin is referred to as the original of the common non-steroid anti-inflammatory drugs and is used as a comparison measure to new ones. Aspirin, whose active ingredient is acetylsalicylic acid, combines strong antipyretic, analgesic, anti-inflammatory and anti-coagulant action. For the latter, aspirin is administered on an ongoing basis to patients for the prevention of cardiovascular events or recurrence of cerebral throm- bosis and therapeutically to patients with a history of heart attack or ischemic stroke. Taking aspirin as an anticoagulant chronic medication concerns dentists es- pecially when it comes to surgical procedures as it is likely to cause increased bleeding perioperatively. The management of the patient on aspirin varies depending on the reason aspirin is administered and its dosage, the co-administration of other antiplatelet or anticoagulant drugs and the severity of the surgical procedure itself. An interruption of antiplatelet medication is decided after assessing the above-mentioned criteria and con- sulting the patient’s physician. Additionally, in cases of increased bleeding risk like complex extractions, pre- prosthetic surgery, periodontal surgery, the procedure needs to be performed as atraumatically as possible and be accompanied by local haemostatic measures.

2003 ◽  
Vol 21 (4) ◽  
pp. 377-388
Author(s):  
M. Y. Hasan ◽  
M. Das ◽  
A. Bener

The present study examined the pattern of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in relation to the source of advice. Ten community pharmacies in the United Arab Emirates were randomly selected and patients visiting these sites were interviewed using a standard questionnaire. The interview covered “source of advice,” “name of medicine,” “type of disease,” “duration of disease,” and “knowledge of adverse effects and drug interactions.” After a month the patients were contacted. On average 22.7% of prescriptions contained NSAIDs and 17.5% of visits were for these drugs. Advice from physicians was given to 33.3%, from pharmacists 32.5%, from friends 18.8%, and 15.4% depended on themselves. Other medicines were taken by 14.5% and 12% suffered from gastrointestinal upsets. Paracetamol followed by ibuprofen and diclofenac were the most frequently utilized agents. Headache, fever, and musculoskeletal pain were the common complaints. A month later, 50.7% of the patients continued taking their medications. This study revealed an association between the source of advice and knowledge of side effects. It is argued that, although self-care is important, professional advice in its support is essential since unsupervised self-medication exposes the patient to harmful consequences.


1999 ◽  
Vol 13 (2) ◽  
pp. 143-145 ◽  
Author(s):  
CJ Hawkey

Heliobacter pyloriand nonsteroidal anti-inflammatory drugs (NSAIDs) cause ulcers by different mechanisms. Under some circumstances, patients infected withH pylorimay be less prone to NSAID-associated ulcers than those who areH pylori-negative. Eradication trials have yielded differing results. However, those who have studied patients who have a past history of ulcer disease and are already established on NSAIDs have shown no benefit fromH pylorieradication.


2009 ◽  
Vol 17 (1) ◽  
pp. 119-122 ◽  
Author(s):  
CK Chiu ◽  
VA Singh

We report a case of chronic recurrent multifocal osteomyelitis in a 9-year-old girl. She presented with a 9-month history of gradually worsening pain and swelling in her left foot. Non-steroidal anti-inflammatory drugs were prescribed but the symptoms persisted. She underwent curettage through a small oval corticotomy window on the first metatarsal bone. The pain and swelling improved promptly and she was able to walk without pain 2 weeks later. Curettage enabled rapid symptomatic relief and induced remission, with little risk of complications.


2012 ◽  
Vol 108 (07) ◽  
pp. 183-190 ◽  
Author(s):  
Andreas Kurth ◽  
Andreas Clemens ◽  
Herbert Noack ◽  
Bengt Eriksson ◽  
Joseph Caprini ◽  
...  

SummaryPatients undergoing total hip or knee arthroplasty should receive anticoagulant therapy because of the high risk of venous thromboembolism. However, many are already taking non-steroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA) that can have antihaemostatic effects. We assessed the bleeding risk in patients treated with thromboprophylactic dabigatran etexilate, with and without concomitant NSAID or ASA. A post-hoc analysis was undertaken of the pooled data from trials comparing dabigatran etexilate (220 mg and 150 mg once daily) and enoxaparin. Major bleeding event (MBE) rates were determined and odds ratios (ORs) generated for patients who received study treatment plus NSAID (half-life ≤12 hours) or ASA (≤160 mg/day) versus study treatment alone. Relative risks were calculated for comparisons between treatments. Overall, 4,405/8,135 patients (54.1%) received concomitant NSAID and 386/8,135 (4.7%) received ASA.ORs for the comparison with/without concomitant NSAID were 1.05 (95% confidence interval [CI] 0.55–2.01) for 220 mg dabigatran etexilate; 1.19 (0.55–2.55) for 150 mg; and 1.32 (0.67–2.57) for enoxaparin. ORs for the comparison with/without ASA were 1.14 (0.26–5.03); 1.64 (0.36–7.49); and 2.57 (0.83–7.94), respectively. For both NSAIDs and ASA there was no significant difference in bleeding between patients with and without concomitant therapy in any treatment arm. Patients concomitantly taking NSAIDs or ASA have a similar risk of MBE to those taking dabigatran etexilate alone. No significant differences in MBE were detected between dabigatran etexilate and enoxaparin within comedication subgroups, suggesting that no increased major bleeding risk exists when dabigatran etexilate is administered with NSAID or ASA.Investigation performed at multiple centres participating in the RE-MODEL™, RE-NOVATE®, and RE-MOBILIZE® trials.


Author(s):  
Mona Talaschian ◽  
Anahita Sadeghi ◽  
Sara Pakzad

Antimalarial agents, including chloroquine and hydroxychloroquine, have been used for the treatment of various rheumatoid diseases and skin diseases because of their anti-inflammatory and immune-modulating properties. Cutaneous adverse effects such as exacerbation of psoriasis, pruritus, and hyperpigmentation have been reported as side-effects of antimalarial drugs. In this case, we report a middle-aged man with a history of rheumatoid arthritis who was treated with non-steroidal anti-inflammatory drugs and hydroxychloroquine. He complainedof hyperpigmentation of the face after one year of initiating the hydroxychloroquine. It was discontinued and methotrexate was started. Skin biopsy was confirmed drug reaction. Aftermore than 10 years of follow up, his skin discoloration had not been improved.


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