Anticoagulants are medicines that thin the blood and prevent blood from clotting. They also help to break the blood clot present in the body and prevent it from forming again and again. This medication is also helpful in preventing other life-threatening conditions such as heart attacks, strokes, and pulmonary embolisms. Anticoagulant medication is in different forms, such as oral medications, intravenous(IV) drugs, and injections.
Types of Anticoagulants:
Warfarin is the most commonly prescribed anticoagulant in treating many diseases. Other types of anticoagulants include:
- Dabigatran(Eliquis)
- Edoxaban(Lixiana)
- Rivaroxaban(Xarelto)
- Apixaban(Eliquis)
Heparin can also be an anticoagulant used in injection, and warfarin is a new alternative used as tablets or capsules.
Use of Anticoagulants:
Anticoagulant medications are usually used in several diseases but treat the blood clot that causes these diseases. When blood clots form in a person’s body, as at the place of an injury that requires repair, there is a chance it can travel with the bloodstream and get stuck in any small blood vessel, if the small blood vessel is present in a critical location in the body, it can block the blood flow of that organ, which leads to severe issues such as:
- Stroke: This condition can happen if the blood clot travels to your brain and strikes a small blood vessel.
- Heart attack: If the blood clot gets stuck in any artery of the heart and blocks the blood flow, this situation ultimately leads to a heart attack.
- Pulmonary Embolism (PE): This condition usually happens when the blood clot travels to the lungs and gets stuck in the lungs’ artery. It blocks the blood flow in the lungs, and if the blockage can be severe, it also leads to death.
Disease or condition treated with Anticoagulants:
Some diseases treated through anticoagulants are:
- Heart valve surgery or replacement: Heart valve surgery and replacement increase the risk of blood clots at the site of new valves. Anticoagulant medication helps to prevent blood clots in these conditions.
- Atrial fibrillation: Atrial fibrillation is the irregular heartbeat in the heart’s upper chambers. In this condition, blood can pool because the heart’s upper chambers beat fast enough, affecting blood flow. Pooling blood can easily clot, and the blood clot can travel from your heart to the brain, leading to a stroke. Anticoagulant such as eliquis is also helpful in preventing this condition.
- Blood clotting disorders: Anticoagulant medication is also helpful in blood clotting disorders because blood clotting disorders can be inherited and transferred from generation to generation.
- Hip and knee replacement: Hip or knee joint replacement can increase the risk of a blood clot in the veins of the legs; this condition is called Deep vein thrombosis and can also lead to pulmonary Embolism. Eliquis is a medicine used in this condition to prevent severe blood clots.
Working of Anticoagulants:
The human body can balance the clotting and anticlotting process. If the blood clotting process slows down or stops, in severe cases such as in an accident or injury, the body loses enough blood, which can also lead to death. In injury, blood clotting protects the body from excessive blood loss and makes a protective covering to keep the germs and debris out of the wound. Anticoagulant medication may disturb the normal clotting process and undo coagulation. The clotting process disruption happens in different ways, and it depends on the type of anticoagulant you take:
IV and injectable medications:
Some of the injectable medications are the following:
- Heparin and its derivatives:
Heparin is a medication that activates the anticlotting process in the body and prevents clotting. Blood proteins activate the anticlotting function is antithrombin; Heparin starts antithrombin and stops normal blood clotting in a specific body part.
Types of heparin are:
- Unfractionated heparin (UFH): Unfractionated Heparin is stronger and fast-acting medication. UFH has a longer molecule that wraps both thrombin and antithrombin and controls the blood clotting in specific body parts. This medication also needs constant monitoring because its high dosage cause bleeding, and a low dosage do not prevent blood clotting.
- Low-molecular-weight heparin (LMWH): This medication has a shorter molecule than UFH and only attaches to antithrombin. LMWH does not need constant monitoring, and its effects are long-lasting and more predictable.
- Fondaparinux: Fondaparinux is a synthetic medication that works like heparin. It also activates antithrombin and works for a more extended period. This medication is not firmly compared to LMWH and UFH; that’s why it is used to prevent blood clotting rather than treat it.
- Direct thrombin inhibitors:
Direct thrombin inhibitors are only used to prevent blood clotting by attaching to the thrombin after certain medical conditions. Direct thrombin inhibitors include bivalirudin, argatroban, and desirudin, which are used as an alternative to heparin and its variants.
Oral medications
Oral medications include the following medicines:
- Warfarin(vitamin K antagonist): As the name indicates, warfarin is a vitamin K antagonist, which is the main ingredient used for blood clotting. The patient needs to take careful doses of warfarin because the excessive amount can cause severe bleeding. It is usually recommended for end-stage kidney diseases, mitral heart valve diseases, and mechanical heart valve conditions.
- Direct oral anticoagulants: These medications include diagatran, betrixaban, apixaban, and edoxanban. These medications prevent blood clotting and are usually recommended when warfarin isn’t an option.
Advantages of Anticoagulants
Anticoagulants effectively prevent life-threatening conditions such as heart attack, stroke, and pulmonary Embolism. It is also helpful in treating many other diseases caused due to blood clots and is also used in different conditions and medical treatments.
Side effects of Anticoagulants
There are also some side effects of taking anticoagulant medications. One of the main side effects is that you bleed too quickly due to blood thinning which can lead to problems such as:
- Severe bruising
- Heavy periods in women
- Blood in urine
- Blood in stools or black stools
- Blood vomiting and blood coming out during coughing
- Bleeding gums
- Nose bleeding for a more extended period
- Excessive and unstoppable bleeding after an accident can also lead to death.
Other possible side effects can include:
- Sickness
- Dizziness
- Indigestion
- Itchy skin and rashes
- Jaundice
- Constipation or diarrhoea
- Headache and hair loss
References:
- https://my.clevelandclinic.org/health/treatments/22288-anticoagulants
- https://www.nhs.uk/conditions/anticoagulants/
- https://www.webmd.com/dvt/anticoagulant-types
- https://medlineplus.gov/bloodthinners.html
- ● https://www.healthline.com/health/anticoagulant-and-antiplatelet-drugs
