Skip to main content
SpringerLink
Log in

Antithrombotics and Antifibrinolytics

  • Chapter
  • First Online:
Handbook of Pediatric Cardiovascular Drugs

  • 1806 Accesses

Abstract

Pediatric thromboembolic events are rare, but the incidence of thrombosis in children has dramatically increased over the last decade and appears to be an increasing problem in pediatric tertiary care hospitals. They usually occur as a complication of a primary disease or treatment. This chapter describes the indications, mechanisms of action, dose regimens, therapeutic ranges and monitoring requirements, pharmacokinetics, contraindications, adverse effects and warnings, drug interactions and side effects of antithrombotic (anticoagulant, antiplatelet, and thrombolytic) agents and antifibrinolytic agents.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Raffini L, Huang YS, Witmer C, Feudtner C. Dramatic increase in venous thromboembolism in children’s hospitals in the United States from, 2001 to 2007. Pediatrics. 2009;124(4):1001–8.

    Article  PubMed  Google Scholar 

  2. Young G. Diagnosis and treatment of thrombosis in children: general principles. Pediatr Blood Cancer. 2006;46:540–6.

    Article  PubMed  Google Scholar 

  3. Monagle P. Thrombosis in pediatric cardiac patients. Semin Thromb Hemost. 2003;29(6):547–55.

    Article  PubMed  Google Scholar 

  4. Monagle P, Chan A, Goldenberg NA, et al. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th Edition). Chest. 2012;141(2 Suppl):e737–801.

    Google Scholar 

  5. Gross PL, Weitz JI. New antithrombotic drugs. Clin Pharmacol Thera. 2009;86(2):139–46.

    Google Scholar 

  6. Eaton MP. Antifibrinolytic therapy in surgery for congenital heart disease. Anesth Analg. 2008;106(4):1087–100.

    Article  CAS  PubMed  Google Scholar 

  7. Hursting MJ, Dubb J, Verme-Gibboney CN. Argatroban anticoagulation in pediatric patients. A literature analysis. J Pediatr Hematol Oncol. 2006;28:4–10.

    Article  CAS  PubMed  Google Scholar 

  8. Malowany JI, Knoppert DC, Chan AK, et al. Enoxaparin use in the neonatal intensive care unit: experience over 8 years. Pharmacotherapy. 2007;27(9):1263–71.

    Article  CAS  PubMed  Google Scholar 

  9. Malowany JI, Monagle P, Knoppert DC, et al. Enoxaparin for neonatal thrombosis: a call for a higher dose for neonates. Thromb Res. 2008;122(6):826–30.

    Article  CAS  PubMed  Google Scholar 

  10. Sanchez de Toledo J, Gunawardena S, Munoz R. Do neonates, infants and young children need a higher dose of enoxaparin in the cardiac intensive care unit? Cardiol Young. 2010;20(2):138–43.

    Article  PubMed  Google Scholar 

  11. Taketomo CK, Hodding JH, Kraus DM. Pediatric Lexi-Drugs. Lexi-Comp© 1978–2012. Hudson,Ohio. http://online.lexi.com Accessed 6–1–2012 to 7–25–12.

  12. Dix D, Andrew M, Marzinotto V, Charpentier K, Bridge S, Monagle P, deVeber G, Leaker M, Chan AK, Massicotte MP. The use of low-molecular-weight heparin in pediatric patients: a prospective cohort study. J Pediatr. 2000;136:439–45.

    Article  CAS  PubMed  Google Scholar 

  13. Monagle P, Michelson AD, Bovill E, et al. Antithrombotic therapy in children. Chest. 2001;119:344S–70.

    Article  CAS  PubMed  Google Scholar 

  14. Dager WE, Gosselin RC, King JH, Christensen CL, et al. Anti-Xa stability of diluted enoxaparin for use in pediatrics. Ann Pharmacother. 2004;38(4):569–73.

    Article  CAS  PubMed  Google Scholar 

  15. Gershanik J, Boecler B, Ensley H, et al. The gasping syndrome and benzyl alcohol poisoning. N Engl J Med. 1982;307:1384–8.

    Article  CAS  PubMed  Google Scholar 

  16. Guyatt GH, Akl EA, Crowther M. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):7–47.

    Article  Google Scholar 

  17. Lee C, Nechyba C, Gunn VL. Drug doses. In: Gunn VL, Nechyba C, editors. The Harriet lane handbook. Philadelphia: Mosby; 2002.

    Google Scholar 

  18. Monagle P, Chalmers E, Chan A, et al. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):887S–968.

    Article  CAS  PubMed  Google Scholar 

  19. Macdonald S. Aspirin use to be banned under 16 year olds. BMJ. 2002;325:988.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Li JS, Yow E, Berezny KY, et al. Dosing of clopidogrel for platelet inhibition in infants and young children: primary results of the Platelet Inhibition in Children On cLOpidogrel (PICOLO) Trial. Circulation. 2008;117(4):553–9.

    Article  CAS  PubMed  Google Scholar 

  21. Balaguru D, Dilawar M, Ruff P, Radtke WA. Early and late results of thrombolytic therapy using tissue-type plasminogen activator to restore arterial pulse after cardiac catheterization in infants and small children. Am J Cardiol. 2003;91(7):908–10.

    Article  CAS  PubMed  Google Scholar 

  22. Wang M, et al. Low-dose tissue plasminogen activator thrombolysis in children. J Pediatr Hematol Oncol. 2003;25:379–86.

    Article  PubMed  Google Scholar 

  23. Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53(7):e25–76.

    Article  PubMed  Google Scholar 

  24. Duncan BW, Hraska V, Jonas RA, Wessel DL, del Nido PJ, Laussen PC, Mayer JE, Lapierre RA, Wilson JM. Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg. 1999;117:529–42.

    Article  CAS  PubMed  Google Scholar 

  25. Wilson JM, Bower LK, Fackler JC, Beals DA, Berhus BO, Kevy SB. Aminocaproic acid decreases the incidence of intracranial hemorrhage and other hemorrhagic complications of ECMO. J Pediatr Surg. 1993;28:536–41.

    Article  CAS  PubMed  Google Scholar 

  26. Horwitz JR, Cofer BR, Warner BH, Cheu HW, Lally KP. A multicenter trial of 6-aminocaproic acid (Amicar) in the prevention of bleeding in infants on ECMO. J Pediatr Surg. 1998;33:1610–3.

    Article  CAS  PubMed  Google Scholar 

  27. Chauhan S, Das SN, Bisoi A, et al. Comparison of epsilon aminocaproic acid and tranexamic acid in pediatric cardiac surgery. J Cardiothorac Vasc Anesth. 2004;18(2):141–3.

    Article  CAS  PubMed  Google Scholar 

  28. Downard CD, Betit P, Chang RW, et al. Impact of AMICAR on hemorrhagic complications of ECMO: a ten-year review. J Pediatr Surg. 2003;38(8):1212–6.

    Article  PubMed  Google Scholar 

  29. Chauhan S, Bisoi A, Kumar N, et al. Dose comparison of tranexamic acid in pediatric cardiac surgery. Asian Cardiovasc Thorac Ann. 2004;12(2):121–4.

    Article  PubMed  Google Scholar 

  30. Reid RW, Zimmerman AA, Laussen PC, Mayer JE, Gorlin JB, Burrows FA. The efficacy of tranexamic acid versus placebo in decreasing blood loss in pediatric patients undergoing repeat cardiac surgery. Anesth Analg. 1997;84:990–6.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacy, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Donald Berry BSPharm

  2. Division of Hematology/Oncology, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Sriya Gunawardena MBBS

Authors
  1. Donald Berry BSPharm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sriya Gunawardena MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donald Berry BSPharm .

Editor information

Editors and Affiliations

  1. Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Ricardo Munoz

  2. Children’s Hospital Colorado, Aurora, Colorado, USA

    Eduardo M. da Cruz

  3. Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Carol G. Vetterly

  4. Cincinnati Children’s Hospital, Cincinnati, USA

    David S. Cooper

  5. Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Donald Berry

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Berry, D., Gunawardena, S. (2014). Antithrombotics and Antifibrinolytics. In: Munoz, R., da Cruz, E., Vetterly, C., Cooper, D., Berry, D. (eds) Handbook of Pediatric Cardiovascular Drugs. Springer, London. https://doi.org/10.1007/978-1-4471-2464-1_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2464-1_13

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2463-4

  • Online ISBN: 978-1-4471-2464-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation