Anticoagulants and Antiplatelet Agents

Chapter

Abstract

The use of anticoagulant and antiplatelet medications is becoming more prevalent in the first world secondary to aging populations and expanding indications for use of these agents in the face of prothrombotic states such as coronary artery disease, cerebrovascular disease, atrial fibrillation, and venous thromboembolic (VTE) disease (Kannel et al. Am J Cardiol 82(7):2N–9N, 1998). Increased age is among risk factors for these conditions. Similarly, elderly patients are at especially high risk of falls and motor vehicle-related injuries and, thus, represent an increasingly larger proportion of trauma patients encountered annually (Coleman et al. Am J Surg 212:1237–42, 2016). Altogether, these trends mean that trauma care providers are encountering a growing number of acutely injured (and potentially bleeding) patients on anticoagulant and antiplatelet medications. This chapter will provide a discussion of when to suspect that one (or more) of these agents may be active within an injured patient and how to optimize the care of these individuals in the face of a very difficult problem: active hemorrhage in the setting of pharmacologic/iatrogenic coagulopathy, which may or may not be reversible.

Keywords

Anticoagulation Warfarin Antiplatelet Bleeding Reversal 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Divisions of General Surgery Trauma & Critical Care MedicineUniversity of TorontoTorontoCanada
  2. 2.Department of Trauma & Acute Care SurgerySt. Michael’s Hospital, University of TorontoTorontoCanada

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