Bleeding complications of unfractionated heparin.

Abstract:

INTRODUCTION:Unfractionated heparin is an anticoagulant used in the treatment of myocardial infarction, pulmonary embolism and other thrombotic disorders. However, with anticoagulation comes the risk of bleeding and adverse events. These risks increase with supratherapeutic dosing. AREAS COVERED:In this review, we discuss the reasons for supratherapeutic dosing, and the incidence of adverse events and clinical consequences of the same, with a focus on heparin use in acute coronary syndromes. We also provide some opportunities for safer use of intravenous heparin. At the end of this article, the reader should have a better understanding of the proper use of heparin as well as the magnitude of bleeding and a respect for its consequences. EXPERT OPINION:Heparin is an indispensable anticoagulant used in a number of clinical scenarios. Careful attention must be paid to dosing in order to minimize the risk of bleeding and related adverse events including death. The use of weight-based nomograms is paramount. Devices to automate testing and titration are currently under development.

journal_name

Expert Opin Drug Saf

authors

Krishnaswamy A,Lincoff AM,Cannon CP

doi

10.1517/14740338.2011.521150

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

77-84

issue

1

eissn

1474-0338

issn

1744-764X

journal_volume

10

pub_type

杂志文章,评审
  • Unresolved gustatory, olfactory and auditory adverse drug reactions to antibiotic drugs: a survey of spontaneous reporting to Eudravigilance.

    abstract::Objectives: Sensory adverse drug reactions (ADRs) are generally expected to be transient in nature. However, spontaneous reports describe frequently these events as long-lasting or unresolved. In this study, the authors reviewed the Eudravigilance publicly accessible database to describe the volume and expectedness of...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2019.1676724

    authors: Ferraro S,Convertino I,Leonardi L,Blandizzi C,Tuccori M

    更新日期:2019-12-01 00:00:00

  • Safety and tolerability of injectable lipid-lowering drugs: an update of clinical data.

    abstract:INTRODUCTION:Cardiovascular (CV) diseases are the leading cause of death and disability in the developed countries. Lipid-lowering therapy is a cornerstone of the CV risk modification strategy. The first line treatment for hyperlipidemia is statins, which decrease low-density lipoprotein cholesterol (LDL-C) by 30-50% a...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2019.1620730

    authors: Strilchuk L,Fogacci F,Cicero AF

    更新日期:2019-07-01 00:00:00

  • The safety of lanreotide for neuroendocrine tumor.

    abstract:INTRODUCTION:Lanreotide autogel is a synthetic somatostatin analogue which has been FDA and EMA approved for unresectable, well to moderately differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumor. Its action is mediated by its affinity to somatostatin receptors, especially sst2 and ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2019.1559294

    authors: Godara A,Siddiqui NS,Byrne MM,Saif MW

    更新日期:2019-01-01 00:00:00

  • Safety of bivalirudin in patients with coronary artery disease.

    abstract:INTRODUCTION:Various limitations of unfractionated heparin (UFH) have triggered a search for new antithrombotic therapies for patients with coronary artery disease (CAD). Bivalirudin is a direct thrombin inhibitor with several pharmacological advantages over UFH and is currently endorsed by practice guidelines, particu...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2012.628312

    authors: Abdel-Wahab M,Richardt G

    更新日期:2012-01-01 00:00:00

  • Safety of secukinumab for the treatment of active ankylosing spondylitis.

    abstract::Introduction: Secukinumab is a fully human monoclonal antibody which targets and neutralizes interleukin (IL)-17A, a cytokine that plays an important role in the pathophysiology of ankylosing spondylitis (AS). Secukinumab is the first IL-17A inhibitor approved for the treatment of AS. Areas covered: This paper aimed t...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2021.1851363

    authors: Loricera J,Galíndez-Aguirregoikoa E,Blanco R

    更新日期:2021-01-20 00:00:00

  • The efficacy and safety of ixabepilone monotherapy in the treatment of breast and gynecologic malignancies.

    abstract::Ixabepilone is a semisynthetic analogue of epothilone B, a novel microtubule-stabilizing agent. Preclinical data suggest that its mechanisms of actions are different from those of the most commonly used microtubule-stabilizing agent, paclitaxel. This information in addition to the cytotoxicity of this drug in taxane-r...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740330802655538

    authors: Gupta D,Mani S

    更新日期:2009-01-01 00:00:00

  • Osteonecrosis of the jaw: what do bisphosphonates do?

    abstract::Osteonecrosis of the jaw is a new disease, partly caused by bisphosphonates. It is commonly assumed that the bisphosphonates somehow cause cell death (osteocyte necrosis) within the jawbone, which makes it prone to chronic infection. In this article, an alternative pathogenetic theory is suggested, based on the normal...

    journal_title:Expert opinion on drug safety

    pub_type: 社论

    doi:10.1517/14740338.5.6.743

    authors: Aspenberg P

    更新日期:2006-11-01 00:00:00

  • Safety considerations when using drugs to treat pruritus.

    abstract::Introduction: Treatment for chronic pruritus ranges from use of topical formulations to newer biologic agents. Targeting treatment to the underlying etiology is key in reducing the burden of disease while avoiding systemic or adverse effects.Areas covered: This review details the effective medical treatments used in v...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2020.1728252

    authors: Fourzali K,Yosipovitch G

    更新日期:2020-04-01 00:00:00

  • Frequency of real-world reported adverse drug reactions in rheumatoid arthritis patients.

    abstract:OBJECTIVES:To describe the cumulative incidences of adverse drug reactions (ADRs) associated with disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) patients from real-world data (RWD), using the DREAM-RA registry, and to compare these with incidence frequencies mentioned in the Summary of Pro...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2020.1830058

    authors: Giraud EL,Jessurun NT,van Hunsel FPAM,van Puijenbroek EP,van Tubergen A,Ten Klooster PM,Vonkeman HE

    更新日期:2020-12-01 00:00:00

  • Comparison of medication adherence in diabetes mellitus patients on human versus analogue insulins.

    abstract::Objetive: This study evaluated the results of treatment adherence scales in two cohorts of patients with diabetes mellitus treated either with human or analogue insulins. METHODS:A cohort study was conducted in diabetes mellitus patients older than 18 that were being treated with human or analogue insulins. Two instr...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2017.1273346

    authors: Machado-Alba JE,Medina-Morales DA,Echeverri-Cataño LF

    更新日期:2017-02-01 00:00:00

  • Oral hypoglycemic agents for gestational diabetes mellitus?

    abstract:INTRODUCTION:Gestational diabetes mellitus (GDM), the most frequent medical complication of pregnancy, is associated with several adverse outcomes over the short- and long-term for both mother and offspring. Standard treatment for GDM consists of insulin injections. Oral hypoglycemic agents (OHAs), on the other hand, a...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2011.521740

    authors: Maymone AC,Baillargeon JP,Ménard J,Ardilouze JL

    更新日期:2011-03-01 00:00:00

  • The safety of pomalidomide for the treatment of multiple myeloma.

    abstract:INTRODUCTION:Pomalidomide, a derivative of thalidomide and member of the immunomodulatory drugs is licenced for use in relapsed and refractory multiple myeloma (RRMM) in Europe, USA, Canada and Japan. AREAS COVERED:This review details all published trials in which pomalidomide has been used in the treatment of myeloma...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2016.1154039

    authors: Jones JR,Pawlyn C,Davies FE,Morgan GJ

    更新日期:2016-01-01 00:00:00

  • Pegylated-interferon-α(2a) in clinical practice: how to manage patients suffering from side effects.

    abstract:INTRODUCTION:The goal of antiviral therapy in patients with chronic hepatitis C is to slow or halt the progression of fibrosis and prevent the development of cirrhosis. Accordingly, antiviral treatment is proposed for a large population of patients with chronic hepatitis. AREAS COVERED:The standard-of-care for chronic...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2011.559161

    authors: Calvaruso V,Mazza M,Almasio PL

    更新日期:2011-05-01 00:00:00

  • Cardiovascular effects of anti-diabetes drugs.

    abstract:INTRODUCTION:Cardiovascular disease remains the major contributor to morbidity and mortality in diabetes. From the need to reduce cardiovascular risk in diabetes and to ensure that such risk is not exacerbated by drug treatments, governmental regulators and drug manufacturers have focused on clinical trials evaluating ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2016.1195368

    authors: Younk LM,Lamos EM,Davis SN

    更新日期:2016-09-01 00:00:00

  • The safety of JAK kinase inhibitors for the treatment of myelofibrosis.

    abstract:INTRODUCTION:During the last decade, the development of small molecule inhibitors of Janus kinases (JAKi) contributed to revolutionize the therapeutic landscape of myelofibrosis (MF). JAKi proved to be effective in controlling disease-related symptoms and splenomegaly with remarkable inter-drug variability. However, in...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2021.1865912

    authors: Coltro G,Vannucchi AM

    更新日期:2020-12-27 00:00:00

  • Clozapine's critical role in treatment resistant schizophrenia: ensuring both safety and use.

    abstract:INTRODUCTION:Clozapine was first introduced as an antipsychotic in the 1970's but a cluster of deaths, later linked to the drug's risk of agranulocytosis, led to its withdrawal in most countries. However, work in the 1980's established its unique efficacy in treatment resistant schizophrenia (TRS), which constitutes as...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2016.1191468

    authors: Remington G,Lee J,Agid O,Takeuchi H,Foussias G,Hahn M,Fervaha G,Burton L,Powell V

    更新日期:2016-09-01 00:00:00

  • Are salt loading and prolonging infusion period effective in prevention of amphotericin B-induced nephrotoxicity?

    abstract:INTRODUCTION:Nephrotoxicity is generally considered as the most clinically significant adverse reaction of amphotericin B, and has been reported in up to 80% of amphotericin B recipients during the first 2 weeks of treatment. Numerous experimental and clinical investigations have been performed over the past 4 decades,...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2012.721775

    authors: Karimzadeh I,Farsaei S,Khalili H,Dashti-Khavidaki S

    更新日期:2012-11-01 00:00:00

  • Assessment of the quality of medication information for patients in Spain.

    abstract:OBJECTIVE:To analyze the extent to which Spanish leaflets and drug information on the Net met quality criteria. RESEARCH DESIGN AND METHODS:A descriptive study was conducted comparing readability (REA) and comprehensibility (COM) criteria of a random sample of 77 marketed products of the 12 active ingredients most fre...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1517/14740338.2013.744965

    authors: Mira JJ,Lorenzo S,Pérez-Jover V,Navarro I,Martín de Rosales AM,Lara C

    更新日期:2013-01-01 00:00:00

  • COX-2 selective inhibitors: analysis of the renal effects.

    abstract::COX-2 selective inhibitors provide analgesia and blunt inflammation while also sparing the gastrointestinal tract from classic NSAID toxicity. Therapeutic effects are thought to result from inhibition of the inflammatory COX-2 isoform. Organ sparing is considered the result of preservation of homeostatic COX-1 enzyme ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.1.1.53

    authors: Perazella MA

    更新日期:2002-05-01 00:00:00

  • The risk of cardiovascular complications with current obesity drugs.

    abstract:INTRODUCTION:Obesity is associated with an increased risk of cardiovascular morbidity and mortality. Four medications are approved by the US Food and Drug Administration (FDA) for chronic weight management when used as an adjunct to a reduced-calorie diet and increased physical activity in adults. These medications res...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章

    doi:10.1080/14740338.2020.1806234

    authors: Chao AM,Wadden TA,Berkowitz RI,Quigley K,Silvestry F

    更新日期:2020-09-01 00:00:00

  • Metabolic complications associated with antiretroviral therapy in HIV-infected and HIV-exposed uninfected paediatric patients.

    abstract:IMPORTANCE OF THE FIELD:HIV-infection has become a chronic disease in paediatric patients with the potential for long-term survival and exposure to antiretroviral (ARV) therapies for 2 decades longer than HIV-infected adults. On the other hand, the administration of ARV to HIV-infected pregnant women has greatly increa...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740330903579991

    authors: Viganò A,Cerini C,Pattarino G,Fasan S,Zuccotti GV

    更新日期:2010-05-01 00:00:00

  • Examining the safety of amiodarone.

    abstract:INTRODUCTION:Amiodarone is the most widely used antiarrhythmic agent, with demonstrated effectiveness against all the spectrum of cardiac tachyarrhythmias. The risk of adverse effects acts as a limiting factor to its utilization especially in the long term. This article systematically reviews the published evidence on ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2012.660915

    authors: Santangeli P,Di Biase L,Burkhardt JD,Bai R,Mohanty P,Pump A,Natale A

    更新日期:2012-03-01 00:00:00

  • Do we need to worry about mycophenolate overdose?

    abstract:INTRODUCTION:To discuss the significance of the recent observational case series from the Swiss Toxicological Information Centre (STIC). Mycophenolic acid (MPA) and its prodrug mycophenolate mofetil are immunosuppressive agents that are frequently prescribed in renal transplant recipients, and their safety profiles mus...

    journal_title:Expert opinion on drug safety

    pub_type: 评论,社论

    doi:10.1517/14740338.2014.905540

    authors: Filler G,Ferrand A

    更新日期:2014-05-01 00:00:00

  • 14th Annual Meeting of the Safety Pharmacology Society: threading through scientific sessions for originality and novelty.

    abstract:INTRODUCTION:The Annual Meeting of the Safety Pharmacology (SP) Society is a yearly event designed to keep attendees abreast of how to best identify and mitigate organ function liabilities of candidate drugs selected for clinical assessment. AREAS COVERED:Heart rate (HR) and blood pressure (BP) effects of candidate dr...

    journal_title:Expert opinion on drug safety

    pub_type:

    doi:10.1517/14740338.2015.1034104

    authors: Cavero I

    更新日期:2015-06-01 00:00:00

  • The clozapine to norclozapine ratio: a narrative review of the clinical utility to minimize metabolic risk and enhance clozapine efficacy.

    abstract::Introduction: Clozapine remains the most effective antipsychotic for treatment-refractory schizophrenia. However, ~40% of the patients respond insufficiently to clozapine. Clozapine's effects, both beneficial and adverse, have been proposed to be partially attributable to its main metabolite, N-desmethylclozapine (NDM...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2020.1698545

    authors: Costa-Dookhan KA,Agarwal SM,Chintoh A,Tran VN,Stogios N,Ebdrup BH,Sockalingam S,Rajji TK,Remington GJ,Siskind D,Hahn MK

    更新日期:2020-01-01 00:00:00

  • Risk of adverse events in lymphoma patients treated with brentuximab vedotin: a systematic review and meta-analysis.

    abstract::Objectives: To assess the risk of adverse events (AEs) associated with brentuximab vedotin in lymphoma patients.Methods: Articles were retrieved from PubMed, Cochrane, and Clinicaltrials Databases to identify randomized controlled trials (RCTs) comparing brentuximab vedotin with non-brentuximab vedotin in lymphoma pat...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,meta分析

    doi:10.1080/14740338.2020.1718103

    authors: Gao S,Zhang M,Wu K,Zhu J,He Z,Li J,Chen C,Qiu K,Yu X,Wu J

    更新日期:2020-05-01 00:00:00

  • Safety of secukinumab in the treatment of psoriasis.

    abstract:INTRODUCTION:Secukinumab is a human monoclonal antibody that selectively targets and neutralizes interleukin (IL)-17A, a cytokine that is normally involved in mucocutaneous defense against extracellular organisms and is abnormally expressed in psoriasis. In 2015, secukinumab was the first IL-17A inhibitor approved for ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1080/14740338.2016.1221923

    authors: Blauvelt A

    更新日期:2016-10-01 00:00:00

  • Probiotics under the regulatory microscope.

    abstract::This review examines current knowledge regarding the safety of probiotic bacteria in man. Tighter and more comprehensive standards and regulations will be developed as probiotic therapy moves from a limited number of products used in the food industry, into more defined therapeutic categories and more complex organism...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.4.6.1135

    authors: Henriksson A,Borody T,Clancy R

    更新日期:2005-11-01 00:00:00

  • The safety and usefulness of low molecular weight heparins and unfractionated heparins in patients with acute stroke.

    abstract::Stroke is a common cause for morbidity and mortality, causing substantial economic costs. Because thrombosis plays a key role in the pathogenesis of ischaemic stroke, heparins, platelet inhibitors and anticoagulants have been used in stroke management. There were high hopes that patients might benefit from the use of ...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740330903150157

    authors: Kiphuth IC,Köhrmann M,Huttner HB,Schellinger PD

    更新日期:2009-09-01 00:00:00

  • Drugs with anticholinergic properties: a current perspective on use and safety.

    abstract:INTRODUCTION:Many commonly used drugs have primary or secondary anticholinergic effects contributing to adverse outcomes ranging from mild-to-severe to potentially lethal. Anticholinergic adverse effects frequently occur with medications prescribed with other intended mechanisms of action, including antihistamines, ant...

    journal_title:Expert opinion on drug safety

    pub_type: 杂志文章,评审

    doi:10.1517/14740338.2011.579899

    authors: Gerretsen P,Pollock BG

    更新日期:2011-09-01 00:00:00