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العنوان
Anticoagulants in critically ill patients in Intensive Care Units
المؤلف
Mohammed ,Hassan Ibrahim Hassan
هيئة الاعداد
باحث / Mohammed Hassan Ibrahim Hassan
مشرف / Hala Gomaa Salama
مشرف / Hazem Mohamed Fawzy
مشرف / Ahmed Kamal Mohammed
الموضوع
Management of complications of anticoagulants -
تاريخ النشر
2011
عدد الصفحات
141.p:
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2011
مكان الإجازة
جامعة عين شمس - كلية الطب - INTENSIVE CARE
الفهرس
Only 14 pages are availabe for public view

from 141

from 141

Abstract

Since its discoverage and uptill now, anticoagulants with all of its types (UFH, LMWHs, warfarin and antiplatelets) play an important role in ICU patients. As after the success of isolation of an anticoagulant from the liver (hepar) and so its naming ”heparin” which was followed by studying of its pharmacotherapeutic properties then its usage efficiently in treating post-surgical DVT patients at early 1930s, this was at the same era when another scientists discovered another drug, its ingestion caused a bleeding disease in cattles, known later by warfarin. So anticoagulants was looked after as one of the most important ICU drugs and by 1999 warfarin was one of the most frequently prescribed drugs in USA.
The role of anticoagulants is not only therapeutic( as in treating MI, PE, DVT and strokes) but also it has a prophylactic role against the incidence of many vascular accidents and so decreasing mortality and morbidity rates and minimizing the periods of ICU stay.
And so the understanding of the pharmacology of anticoagulants and the awareness of its complications, drug interactions, precautions in its use with some patients (e.g. renal failure patients) ,monitoring of its action and dealing with different complications had led to a more safer usage and manufacturing of new drugs with more efficacy and lesser complications.
Because the non-monitored use of these drugs is very harmful and may be life threatening; so the monitoring of action of such drugs regularly is important to protect against higher or lower blood level of these drugs. Heparin, for example, can be monitored by measuring activated partial thromboplastin time (APTT), warfarin levels canbe monitored through prothrombin time (PT) and international normalized ratio (INR) and antiplatelets efficacy is tested by different laboratory tests.
The complications of anticoagulants are not all hemorrhagic. For example, heparin can cause what is called heparin induced thrombocytopenia (HIT) in which heparin use must be stopped and another drugs should be administrated. Warfarin induces skin necrosis and acetylsalicylic acid can cause what is called aspirin resistance.
The different types of anticoagulants, doses, routes and periods of treatment had led to the well established guidelines which can deal with different medical and surgical problems.