Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Heparin has been used in clinical practice since 1936 as anticoagulant for: the treatment of thromboembolic disorders, the prevention of deep vein thrombosis and pulmonary embolism and the maintenance of blood fluidity in extracorporal circuits. Its use in these indications has been complicated by an increased risk of hemorrhage such as major bleeding during the treatment of pulmonary embolism and wound hematoma after surgery. Bleeding problems associated with the use of heparin in extracorporal circuits are the following: hemorrhages after cardiopulmonary bypass, serious hemorrhagic complications in patients treated with hemodialysis during acute renal failure and in patients on chronic intermittent hemodialysis and increased occult blood loss from the gastrointestinal tract and from other sites. The precise contribution of the use of heparin to the enhanced bleeding in these conditions has not yet been established. The effects on platelets, coagulation factors and/or fibrinolytic activity by the exposure of blood to foreign surfaces together with uremia present in hemodialysis patients may also contribute to abnormalities in clinical hemostasis. Recently heparin fractions and a heparinoid of low molecular weight (LMW) have been developed because of their potential to diminish the hazard of hemorrhage while retaining their antithrombotic properties. Preliminary reports from pilot studies have confirmed the increased efficacy in preventing deep vein thrombosis (DVT) of some of the new LMW heparin(oid)s; however, improved safety with regard to bleeding still needs to be shown. The use of LMW heparins and of a new LMW heparinoid in acute and chronic hemodialysis has also been shown to be effective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heparin and its biocompatibility. 243 41

Heparin, a commonly used anticoagulant agent, is frequently used in patients undergoing hemodialysis. As with most medications, heparin has a significant side effect profile. Two of its most important side effects, major bleeding and hyperkalemia, may be devastating without immediate diagnosis and treatment. Major bleeding such as gastrointestinal, genitourinary or intracranial bleeding is occasionally encountered and rarely neglected. However, heparin-induced cardiac tamponade is rarely encountered and may be easily overlooked. Another side effect, heparin-induced hyperkalemia, an unusual but well-described side effect, is frequently forgotten until life-threatening arrhythmia has occurred. We report a case involving a 40-year-old male patient with uremia, who had received heparin for 10 days for deep vein thrombosis in the left lower extremity. Hemopericardium with cardiac tamponade and life-threatening hyperkalemia were both noted in this patient.
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PMID:Heparin-induced cardiac tamponade and life-threatening hyperkalema in a patient with chronic hemodialysis. 1587 38

Oral anticoagulants are commonly used drugs in patients with CKD and patients with ESKD to treat atrial fibrillation to reduce stroke and systemic embolism. Some of these drugs are used to treat or prevent deep venous thrombosis and pulmonary embolism in patients with CKD who undergo knee and hip replacement surgeries. Warfarin is the only anticoagulant that is approved for use by the Food and Drug Administration in individuals with mechanical heart valves. Each oral anticoagulant affects the coagulation profile in the laboratory uniquely. Warfarin and apixaban are the only anticoagulants that are Food and Drug Administration approved for use in patients with CKD and patients with ESKD. However, other oral anticoagulants are commonly used off label in this patient population. Given the acquired risk of bleeding from uremia, these drugs are known to cause increased bleeding events, hospitalization, and overall morbidity. Each anticoagulant has unique pharmacologic properties of which nephrologists need to be aware to optimally manage patients. In addition, nephrologists are increasingly asked to aid in the management of adverse bleeding events related to oral anticoagulant use in patients with CKD and patients with ESKD. This article summarizes the clinical pharmacology of these drugs and identifies knowledge gaps in the literature related to their use.
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PMID:Clinical Pharmacology of Oral Anticoagulants in Patients with Kidney Disease. 3090 1