| Abstrakt: |
An increasing number of deaths have been attributed to hemorrhagic diathesis complicating bishydroxycoumarin (Dicumarol) therapy. Since its introduction to clinical use in 1941, a variety of indications have been described for the use of orally given anticoagulants.1 These include nonfatal pulmonary embolism, primary and postoperative phlebothrombosis and thrombophlebitis, sudden embolic or thrombic arterial occlusion, postoperative venous thrombosis or embolism, and myocardial infarction.The hazards of anticoagulation have also been emphasized. Duff and Shull,2 in their review of the first 23 fatalities due to bishydroxycoumarin therapy, summarized the most commonly encountered contraindications. Significant hepatic or renal insufficiency leads their list. Included, too, are ulcerative lesions of the gastrointestinal tract, blood dyscrasias with associated bleeding tendencies, subacute bacterial endocarditis, threatened and incomplete abortions, and obstetric cases near term. HISTORICAL BACKGROUND The basic investigations of Solandt and others3 paved the way for the current widespread use of anticoagulants in the |
