Pediatric Patent Foramen Ovale Atrial Septal Defects Medication

Updated: Sep 16, 2019
  • Author: Barry A Love, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Medication

Anticoagulants

Class Summary

These agents are used to prevent recurrent or ongoing thromboembolic occlusion. Systemic anticoagulation may be indicated for patients with patent foramen ovale (PFO) and history of stroke or those at a significantly increased risk for paradoxical embolus.

Warfarin (Coumadin)

Interferes with hepatic synthesis of vitamin K-dependent coagulation factors. Used for prophylaxis and treatment of venous thrombosis, pulmonary embolism, and thromboembolic disorders. Tailor dose to maintain an INR in the range of 2-3.

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Antiplatelets

Class Summary

Aspirin, at doses of 3-5 mg/kg daily, acts as an antiplatelet agent and appears to reduce the risk of recurrent stroke in patients with cryptogenic stroke and patent foramen ovale.

Aspirin (Anacin, Bayer)

Stronger inhibitor of both prostaglandin synthesis and platelet aggregation than other salicylic acid derivatives. Acetyl group is responsible for inactivation of cyclooxygenase via acetylation. Hydrolyzed rapidly in plasma, and elimination follows zero-order pharmacokinetics.

Irreversibly inhibits platelet aggregation by inhibiting platelet cyclooxygenase. This, in turn, inhibits conversion of arachidonic acid to PGI2 (potent vasodilator and inhibitor of platelet activation) and thromboxane A2 (potent vasoconstrictor and platelet aggregate). Platelet inhibition lasts for the life of the cell (approximately 10 d). May be used in low doses to inhibit platelet aggregation and to improve complications of venous stases and thrombosis. Indicated to prevent recurrent ischemic stroke.

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