RT Journal
A1 DUFF IF, SHULL WH
T1 FAtal hemorrhage in dicumarol® poisoning
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1949
FD March 19
VO 139
IS 12
SP 762
OP 766
DO 10.1001/jama.1949.02900290008003
UL http://dx.doi.org/10.1001/jama.1949.02900290008003
AB The hazard of hemorrhagic diatheses resulting from the use of dicumarol® has been repeatedly emphasized, and considerable accumulated clinical experience has established definite contraindications to its prescription. As outlined by Barker1 and Allen,2 the conditions under which the drug should be used cautiously, if at all, include significant hepatic and renal insufficiency, ulcerative lesions of the gastrointestinal tract, purpura of any type, blood dyscrasias with a bleeding tendency and, particularly, thrombocytopenia, subacute bacterial endocarditis and after recent operations on the brain or spinal cord where even minor degrees of bleeding might be associated with grave consequences. To this list others3 have added severe hypertension, recent threatened abortions and obstetric cases near term. Lack of adequate and reliable laboratory facilities for the daily measurement of prothrombin activity must be regarded as the most important of all contraindications. The official Swedish civil and army medical committee have concluded that