Antiplatelet and anticoagulant therapy in patients with gastrointestinal bleeding: an 86-year-old woman with peptic ulcer disease.
JAMA
; 306(21): 2367-74, 2011 Dec 07.
Article
em En
| MEDLINE
| ID: mdl-22045703
ABSTRACT
Bleeding in the upper gastrointestinal tract is a common medical problem, with an incidence of 48 to 160 cases per 1000 adults per year and a mortality rate of 5% to 14%. The risk of gastrointestinal bleeding is increased with the use of antiplatelet medications including aspirin and clopidogrel, as well as warfarin or a combination of these medications. The recurrence rate for bleeding in patients who continue to take aspirin after an episode of peptic ulcer disease-related bleeding can reach up to 300 cases per 1000 person-years and varies by age, sex, and the use of nonsteroidal anti-inflammatory medications. Using the case of Ms S, an 86-year-old woman who presented to the emergency department with an episode of nonvariceal upper gastrointestinal tract bleeding, we address the management of patients who are receiving antiplatelet or anticoagulation therapy who present with gastrointestinal bleeding, including when to restart antiplatelet or anticoagulation therapy, interventions to reduce the risk of bleeding recurrence, and the potential for drug interactions between clopidogrel and proton pump inhibitors.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Agregação Plaquetária
/
Inibidores da Bomba de Prótons
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Hemorragia Gastrointestinal
/
Anticoagulantes
Limite:
Aged
/
Aged80
/
Female
/
Humans
Idioma:
En
Revista:
JAMA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Arábia Saudita