Alenka Premuš Marušič Kovačič1,2, Martin Caprnda3, Aleš Mrhar2, Peter Kubatka4,5, Igor Locatelli2, Barbora Zolakova6, Ludovit Gaspar7, Robert Prosecky8, Peter Kruzliak9,10, Robert Staffa11, Luis Rodrigo12, Jozef Radonak13, Danijel Petrovič14. 1. Murska Sobota General Hospital, Murska Sobota, Slovenia. 2. Department of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia. 3. 1st Department of Internal Medicine, Faculty of Medicine, University Hospital and Comenius University in Bratislava, Mickiewiczova 2247/13, 811 07, Bratislava, Slovakia. 4. Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Malá Hora 4, 036 01, Martin, Slovakia. peter.kubatka@jfmed.uniba.sk. 5. Department of Experimental Carcinogenesis, Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia. peter.kubatka@jfmed.uniba.sk. 6. Department of Experimental Carcinogenesis, Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia. 7. 1st Department of Internal Medicine, Faculty of Medicine, University Hospital and Comenius University in Bratislava, Mickiewiczova 2247/13, 811 07, Bratislava, Slovakia. ludovit.gaspar@fmed.uniba.sk. 8. Department of Internal Medicine, Brothers of Mercy Hospital, Brno, Polni 3, 63900, Brno, Czech Republic. 9. Department of Internal Medicine, Brothers of Mercy Hospital, Brno, Polni 3, 63900, Brno, Czech Republic. kruzliakpeter@gmail.com. 10. 2nd Department of Surgery, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic. kruzliakpeter@gmail.com. 11. 2nd Department of Surgery, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic. 12. Faculty of Medicine, University of Oviedo, Central University Hospital of Asturias (HUCA), Oviedo, Spain. 13. 1st Department of Surgery, Faculty of Medicine, Pavol Jozef Safarik University and University Hospital, 041 66 Kosice, Slovak Republic. 14. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1104, Ljubljana, Slovenia. daniel.petrovic@mf.uni-lj.si.
Abstract
PURPOSE: This review focuses on the most common drugs administered to surgical patients during the perioperative period that affect the risk of venous thromboembolism (VTE). RESULTS: Among 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. CONCLUSION: Increased monitoring for VTE is therefore advisable in surgical patients and those receiving antipsychotics, antidepressants, diuretics, or analgesics.
PURPOSE: This review focuses on the most common drugs administered to surgical patients during the perioperative period that affect the risk of venous thromboembolism (VTE). RESULTS: Among 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. CONCLUSION: Increased monitoring for VTE is therefore advisable in surgical patients and those receiving antipsychotics, antidepressants, diuretics, or analgesics.
Authors: D Grady; N K Wenger; D Herrington; S Khan; C Furberg; D Hunninghake; E Vittinghoff; S Hulley Journal: Ann Intern Med Date: 2000-05-02 Impact factor: 25.391