Antithrombotic Therapy's archives - Part 3

Treatment of Bleeding Due to Thrombolytic Therapy: Before thrombolytic therapy is used, it is advisable, when possible, to correct other concurrent hemostatic problems, such as thrombocytopenia or vitamin K deficiency. Clinically mild bleeding, which is usually oozing from a wound or puncture site, can be treated with local pressure and supportive care. Major bleeding from […]

Dose Response: Thrombolytic agents are used in low doses, usually to restore catheter patency, and in higher doses to lyse large vessel thrombi or PE. Table 9 presents the most commonly used dose regimens for thrombolytic therapy in pediatric patients with arterial or VTE complications. These protocols come from two level IV studies and several […]

In older children, aspirin rarely causes clinically important hemorrhage, except in the presence of an underlying hemostatic defect or in children also treated with anticoagulants or thrombolytic therapy so buying antibiotics online. The relatively low doses of aspirin used as antiplatelet therapy, as compared to the much higher doses used for anti-inflammatory therapy, seldom cause […]

Therapeutic Range, Dose Response, and Monitoring of Antiplatelet Agents: There is no therapeutic range for or need to monitor aspirin, the most commonly used antiplatelet agent, and no studies that compare different doses of aspirin in children. Empiric low doses of 1 to 5 mg/kg/d have been proposed as adjuvant therapy for Blalock-Taussig shunts, some […]

Adverse Effects of Oral Anticoagulants: Bleeding is the main complication of oral anticoagulants. Minor bleeding, which is of minor clinical consequence (bruising, nosebleeds, heavy menses, coffee-ground emesis, microscopic hematuria, bleeding from cuts and loose teeth, ileostomy), occurs in approximately 20% of children receiving oral anticoagulants (one level IV study). The risk of serious bleeding in […]

Endovascular Stents: Endovascular stents are used increasingly to manage a number of congenital heart lesions, including branch pulmonary arteiy stenosis, pulmonary vein stenosis, and coarctation of the aorta, and to treat postsurgical stenosis. Stents can be successfully used in infants <1 year of age. The small vessel size increases the risk of thrombosis. There are […]

Monitoring: Monitoring oral anticoagulant therapy in children is difficult and requires close supervision with frequent dose adjustments.1 In contrast to adults, only 10 to 20% of children can be safely monitored monthly. Reasons contributing to the need for frequent monitoring include diet, medications, primary medical problems, and age distribution. Breast-fed infants are very sensitive to […]