@article{RamírezSánchez:70467,
author = "Ramírez Sánchez, Ana Belén and Franco García, Mª
Esther",
title = "{Manejo del tratamiento anticoagulante: situaciones
especiales}",
year = "2017",
note = "The thromboembolic disease supposes a major cause of
morbidity and mortality in our country, and for its
prevention and treatment anticoagulants drugs are
necessary. The current and continuous rise of patients with
oral anticoagulant treatment (OAT) has required the
decentralization of the ambulatory control and management
of these patients. The most used anticoagulants in the
community are vitamin K antagonists: acenocumarol y
warfarina; and direct oral anticoagulants: dabigatrán ,
rivaroxabán , apixabán y edoxabán. This document
analyzes the managing of oral anticoagulation in different
and concrete situations wich the anticoagulated outpatients
face. For that purpose, a literature review of some of the
last clinical practice guidelines for anticoagulation has
been done, and it has been compared with daily clinical
practice. The special situations analyzed are: INR out of
range (supra and infratherapeutic INR, and unstable INR),
hemorrhagic complications with OAT, thrombotic
complications with OAT, minor surgical interventions and
endoscopic procedures, gestation, oncological patients, and
pharmacological interactions with rifampicin. Currently,
guidelines and clinical practice, completely agree to the
outpatient anticoagulant management of pregnant women,
oncological patients and mechanical heart prostheses; in
the case of venous thromboembolism the coincidence is also
wide and, it´s in the rest of situations in which
differences are evident when comparing revised clinical
guidelines and daily clinical practice, needing the medical
judgment in order to adapt them to every situation.",
}