Drug-Induced Epistaxis?

Watson, Melanie; Shenoi, P. M.

doi:10.1177/014107689008300312

Cited by 33 publications

(12 citation statements)

References 12 publications

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“…In line with other studies, 3,4 we could show a difference between the ASA prescription rate in the general population and our study patients, identifying ASA as a risk factor for epistaxis in general. Although our comparison should only be regarded as an approximation, it provides an impression of how important ASA is for the practicing ENT doctor.…”

Section: Discussionsupporting

confidence: 93%

“…2 ASA has been shown to be a cause of nontraumatic epistaxis. [3][4][5] As there is little doubt about the benefit of ASA in cardiovascular and cerebrovascular diseases, one could be tempted to prescribe it to any older patient lacking real risk factors, simply because it might be a good protective and is easily affordable. The use of ASA on the same level as other medications to treat non-lifethreatening conditions such as pills against baldness, skin changes, and impotence renders it a lifestyle drug, despite important and dangerous side effects.…”

Section: Introductionmentioning

confidence: 99%

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Is severe epistaxis associated with acetylsalicylic acid intake?

et al. 2009

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Objectives/Hypothesis: Epistaxis represents a very common emergency in any ear, nose, and throat (ENT) department around the world. Despite other risk factors, acetylsalicylic acid (ASA) contributes to nosebleeds by its intrinsic ability to impair thrombocyte aggregation. The aim of this study was to investigate the influence of ASA on the severity of epistaxis and to compare it with other potential risk factors.Study Design: A prospective cohort study was performed at the ENT department of University Hospital Zurich.Methods: A total of 591 events were evaluated concerning surgical interventions and the length of in-hospital stay. Further analyses regarding recurrences and number of treatments and a specially designed severity score, as well as other outcome parameters, were performed.Results: Ninety-nine patients needed to stay inhospital for at least 1 day. Nearly 30% of all patients had ASA intake, and only 18% were on vitamin K antagonist therapy. Patients on ASA showed significantly more surgical interventions, a higher recurrence rate, and a larger number of required treatments as well as an increased severity score. Duration of in-hospital stay and the complication rate, however, were not associated with drug intake.Conclusions: We not only identified ASA to be one of the major risk factors in epistaxis, but also quantified its impact on the severity of nose bleeding. We emphasize the importance of a well-indicated antiaggregational therapy, and strongly discourage using ASA as a life-style drug for the elderly. ASA therapy needs to be discontinued whenever possible and reasonable.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Is severe epistaxis associated with acetylsalicylic acid intake?

et al. 2009

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“…[4][5][6] Alcoholism can cause prolongation of the bleeding time despite normal platelet counts and coagulation profile with altered liver function tests. These patients have either dilated blood vessels (Fig.…”

Section: Ijhnsmentioning

confidence: 99%

Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting

Chhapola¹,

Matta²,

Marker³

2011

International Journal of Head and Neck Surgery

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Aim: To compare the precision and efficacy of endoscopic control versus nasal packing in epistaxis presenting to the emergency room.Design: Open labelled randomized controlled trial for comparison of precision and efficacy of emergency blind nasal packing with primary endoscopic control of epistaxis.Subjects: A total of 160 consecutive patients of epistaxis in the age group of 40 to 70 years were randomized in two groups (A and B) of 80 patients each. Group A was subjected to blind nasal packing and group B to endoscopic procedure. About 48 (30%) patients were alcoholic, 64 (40%) were hypertensive and 48 (30%) patients did not have any overt predisposing factor. Bleeding time, clotting time, prothrombin time, partial thromboplastin time and international normalized ratio (INR) were done in all patients to rule out coagulation diseases. Results:The nasal pack of patients in group A was removed after 48 hours. The nose was endoscopically examined on 3rd day, 7th day and then 1 month after the epistaxis. A total of 44 (55%) patients of group A had nasal mucosal abrasions (p < 0.05), two (2.5%) patients had secretory otitis media (p > 0.05) and 10 (12.5%) had synechiae formation (p > 0.05). A total of 28 (35%) patients from group A had one episode of rebleed after nasal pack removal. Group B had no complications.Conclusion: Epistaxis presenting to the emergency room can be precisely and effectively controlled endoscopically. Clumsy nasal packing, complications and subsequent hospitalization costs are thereby reduced.

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“…2,3 One group indicated that 153 (42%) of 364 ER visits were related to epistaxes. 2 Therefore, patients receiving anticoagulation therapy need to be aware of the increased epistaxis risk associated with such medications.…”

Section: Educating Patients In Self-management Of Epistaxis In An Antmentioning

confidence: 99%

Educating patients in self-management of epistaxis in an anticoagulation clinic

Hassenplug

Burkiewicz

Jackson

et al. 2006

American Journal of Health-System Pharmacy

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The Frontline Pharmacist column gives staff pharmacists an opportunity to share their experiences and pertinent lessons related to day-to-day practice. Topics include workplace innovations, cooperating with peers, communicating with other professionals, dealing with management, handling technical issues related to pharmacy practice, and supervising technicians. Readers are invited to submit manuscripts, ideas, and comments to AJHP,

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Drug-Induced Epistaxis?

Cited by 33 publications

References 12 publications

Is severe epistaxis associated with acetylsalicylic acid intake?

Is severe epistaxis associated with acetylsalicylic acid intake?

Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting

Educating patients in self-management of epistaxis in an anticoagulation clinic

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