Impact of drugs on venous thromboembolism risk in surgical patients

Authors

KOVACIC Alenka Premuš Marušič CAPRNDA Martin MRHAR Aleš KUBATKA Peter LOCATELLI Igor ZOLAKOVA Barbora GASPAR Ludovit PROSECKÝ Robert KRUŽLIAK Peter STAFFA Robert RODRIGO Luis RADONAK Jozef PETROVIC Danijel

Year of publication 2019
Type Article in Periodical
Magazine / Source EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.1007/s00228-019-02636-x
Doi http://dx.doi.org/10.1007/s00228-019-02636-x
Keywords Venous thromboembolism; Analgesics; Diuretics; Antidepressants; Antipsychotics; Oral contraceptives; Surgery; Bridging anticoagulation; Transfusion; Thromboprophylaxis
Description PurposeThis review focuses on the most common drugs administered to surgical patients during the perioperative period that affect the risk of venous thromboembolism (VTE).ResultsAmong analgesics, the risk of VTE is increased in patients treated with diclofenac, ibuprofen, and rofecoxib, but not naproxen, while metamizole can confer a protective effect. The relationship between sedatives and VTE has not been sufficiently studied. Tricyclic antidepressants, low-potency serotonin reuptake inhibitors, and antipsychotics have been associated with increased risk of VTE. The use of diuretics in the perioperative period is poorly researched; however, hyponatremia is considered a risk factor. Other factors that may influence the risk of VTE include bridging anticoagulation, allogeneic transfusion, and hemostatic management before surgery. Pharmacotherapy for HIV or cancer may also increase VTE risk.ConclusionIncreased monitoring for VTE is therefore advisable in surgical patients and those receiving antipsychotics, antidepressants, diuretics, or analgesics.
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