About
UW Medicine

Meet UW Medicine
Anticoagulation Service Pharmacists

About UW Department of
Pharmacy Services
University of Washington
Medical Center
Anticoagulation Services
Modified: Friday, July 20, 2007

PERI-PROCEDURAL ANTICOAGULATION
Terms of Use
Welcome
Clinic Information
Referrals

Referral Form (pdf)
Venous Thromboembolism (VTE)
Optimum Therapeutic Ranges &
Duration of Anticoagulation (pdf)
Warfarin Dose Adjustments
Guidelines for Correction
of Warfarin Over-Anticoagulation
Guidelines for Dosing
& Monitoring Enoxaparin
Peri-Procedural Anticoagulation >
Neuraxial Anesthesia
in the Anticoagulated Patient
Heparin Protocols for UWMC
Heparin-Induced Thrombocytopenia
Central Venous Catheter Management
Alternative Monitoring Options
for Antithrombotic Agents at the
University of Washington
Medical Center
Patient Education
Links to Other Anticoagulation Sites
References (coming soon)
Contact Us

When to Call Your
Anticoagulation
Clinic (pdf)

Table of Contents

  1. Anticoagulation Around Invasive Procedures
    1. Suggestions for Anticoagulation Management Before and After Invasive Procedures (pdf)
    2. Stroke Risk Assessment in Patients with Atrial Fibrillation (CHADS2 Score)
  2. Anticoagulation Around Dental Procedures
    1. Suggestions for Anticoagulation Managemen Before and After Dental Procedures (pdf)
    2. Instructions for Compounding Aminocaproic Acid (ACA) Mouth Rinse
    3. Instructions for Compounding Base Solution for ACA Mouth Rinse

===================================================

I. Anticoagulation Around Invasive Procedures

  1. Suggestions for Anticoagulation Management Before and After Invasive Procedures (pdf)
  2. Stroke Risk Assessment in Patients with Atrial Fibrillation (CHADS2 Score)
  • Point System:

C = Recent CHF exacerbation (1 point).
H = Hx of HTN (even if well controlled now) (1 point).
A = Age>75 (1 point).
D = Diabetes (1 point).
S = Prior cerebral ischemia (TIA or CVA) (2 points).

  • Stroke Risk:

0 points:    1.9%/yr   (low risk)
1 point:   2.8%/yr    (low risk)
2 points:    4.0%/yr    (low risk; high risk if prior cerebral ischemia)
3 points:    5.9%/yr    (moderate risk)
4 points:    8.5%/yr    (moderate risk)
5 points:    12.5%/yr    (high risk)
6 points:    18.2%/yr    (high risk)

  • Reference:

Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001; 285: 2864-70.

II. Anticoagulation Around Dental Procedures

  1. Suggestions for Anticoagulation Management Before and After Dental Procedures (pdf)
  2. Instructions for Compounding Aminocaproic Acid (ACA) 5 % Mouth Rinse
    • COMPONENTS
      • Base Solution 80mL
      • Aminocaproic Acid 5g/20mL
      • 20mL syringe
      • 18G needle
    • DIRECTIONS
      1. Draw up 5g/20mL aminocaproic acid in 20mL syringe
      2. Add 20mL aminocaproic acid to 80mL Formula #2 Mouthwash and mix well
      3. Label appropriately
      4. Expires in 14 day
    • INSTRUCTIONS TO PATIENT
      • Hold 10mL in mouth for 2 minutes, 1/2 hr before dental procedure and then spit out. After procedure, repeat every 2 hours for 6-10 doses until bleeding resolves. May continue as needed.
  3. Instructions for Compounding Base Solution for ACA Mouth Rinse
  • INGREDIENTS (makes 12 x80mL)
  • Polysorbate 20 10ml
  • Spearmint Oil 2.5ml
  • Ethanol 95% 100ml
  • Sod. Saccharin 1GM
  • Sod. Benzoate 2GM
  • Sorbital 70% 100ml
  • Sterile water qs 1000ml (all USP)
  • INSTRUCTIONS
    1. Add the spearmint oil to the polysorbate 20.
    2. Add the ethanol and mix well.
    3. Add the sod. saccharin and sod. benzoate to about 600mL of sterile water.
    4. Add the sorbital to the water solution.
    5. Add the ethanol solution to the water solution and mix will.
    6. QS with water to 1000mL.
    7. Pour 80mL of base into 4oz RX bottles and label.
  • EXPIRATION:
    1. Base Solution: 6 months
    2. Aminocaproic acid 5% mouth rinse : 14 days
Report a Site Problem
©2007, University of Washington Anticoagulation Services.
All Rights Reserved.