COMPLICATION OF ORAL ANTICOAGULANT THERAPY

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ACTA
STOMATOLOGICA
NAISSI

Table of Contents for
Decembar 2015 • Volume 31 • Number 72

PERIORAL AND SUBLINGUAL HEMATOMA – ORAL ANTICOAGULATION THERAPY COMPLICATION – CASE STUDY

Milan Spasić^1,8

Miloš Tijanić^1,2
Dragan Nikolić³
Simona Stojanović²
Nikola Živković^4,2
Jelena Popović^5,2
Predrag Janošević^6,2
Miloš Trajković^7,8
Miloš Stojanović^7,8
Milica B.Petrović⁸

¹ Clinic of Dentistry, Department of Oral Surgery, Niš, Serbia
² University of Niš, Faculty of Medicine, Niš, Serbia
³ Public Health Institute Niš, Niš, Serbia
⁴ Center for Pathology and Pathological Anatomy, Niš, Serbia
⁵ Clinic of Dentistry, Department of Operative Dentistry and Endodontics, Niš, Serbia
⁶ Clinic of Dentistry, Department of Jaw Orthopedics, Niš, Serbia
⁷ Clinic of Dentistry, Department of Maxillofacial Surgery, Niš, Serbia
⁸ postgraduate .student, Faculty of Medicine ,University of Niš

...Abstract

Background: Anticoagulation therapy includes drugs which prevent intravascular formation and spreading of a thrombus. Heparin and dicoumarin preparation are in use.
Heparin preparations are commonly used when a rapid anticoagulant effect is required, they are administered intravenously, act immediately performing the inhibition of thromboplastin activation, prothrombin to thrombin conversion, and the effect of thrombin to fibrinogen.
Oral anticoagulation therapy (OAT) includes drugs – antagonists of vitamin K, which is responsible for the synthesis of prothrombin complex factors – II, VII, IX and X. They are derived from coumarin and indandione. One of the most frequently used drugs from the OAT group is warfarin. It is a competitive inhibitor of vitamin K required for the carboxylation of the residues of PK factor glutamic acid. The results of this inhibition lead to the unsuccessful formation of gama carboxyglutamic acid and the production of functionally inert coagulation proteins.
The aim of this study was to show a rare but dangerous complication of an inadequate application of oral anticoagulation therapy.
Case study. Patient S.S., male, aged 79, was admitted to the Oral Surgery Department, Clinic of Dentistry of the Faculty of Medicine in Niš on October 5, 2012 due to a severe general condition with massive hematoma in the facial area.
Anamnestic data showed that during the previous couple of days, the patient was voluntarily taking a whole tablet of Farin instead of the prescribed dose.
The patient started receiving intravenous low-molecular-weight heparin therapy (Fraxarin 0.3/12h) along with the antibiotic therapy.
In the following period, the patient reported daily at the Oral Surgery Department for regular check-ups. The hematoma was absorbed and the swelling was completely gone within the next 7 to 10 days.
Key words: perioral hematoma, anticoagulation therapy, Farin

... Authors and Reprint Information

Address of correspondence:
Milan Spasić
Clinic of Dentistry Niš
Bul. Zorana Djindjića 52, 18000 Niš
milan.s.spasic@gmail.com 063/8626663