Generic placeholder image

Current Clinical Pharmacology


ISSN (Print): 1574-8847
ISSN (Online): 2212-3938

Review Article

Perioperative Management of Anticoagulants

Author(s): Joan M. Irizarry-Alvarado* and Lynsey A. Seim

Volume 12, Issue 3, 2017

Page: [145 - 151] Pages: 7

DOI: 10.2174/1574884712666170822092709

Price: $65


Background: The prevalence of anticoagulant use has increased in the United States. Medical providers have the responsibility to explain to patients the management of anticoagulant regimens before an invasive procedure. The pharmacologic characteristics of these medications, specifically their half-lives, are important in timing an interruption of anticoagulant therapy.

Objective: The authors review the current guidelines and recommendations for therapeutic interruption of anticoagulants and the involved pharmacologic factors.

Methods: Guidelines and other literature are summarized with discussion on the pharmacology of each medication. Recommendations on how and when to provide bridging for anticoagulants are discussed. Newer oral anticoagulants also are discussed, along with interruption recommendations.

Results: Literature reveals a conservative approach for using bridging when anticoagulation is interrupted because of higher risks of bleeding. Caution is advised when resuming anticoagulant therapy when neuraxial anesthesia is used.

Conclusion: Perioperative healthcare providers need to balance risks and benefits of anticoagulant therapy with its interruption preoperatively.

Keywords: Anticoagulants, bleeding risk, bridging therapy, direct thrombin inhibitors, factor Xa inhibitors, heparin, neuraxial anesthesia, perioperative care, surgery, warfarin.

Graphical Abstract

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy