Wednesday, January 21, 2015

Anticoagulant Therapy

Anticoagulant Therapy

The therapeutic use of anticoagulants is to discourage the blood from clotting.  Anticoagulant use is mainly preventative, the general public usually refers to this type of medication as their “blood thinner.”  Anticoagulants take a thrombolytic action, which means they can destroy a clot and work to improve the condition of ischemia at the location of the specific vessel that is affected,  if a patient is experiencing an event, such as a stroke.  If a patient enters the emergency department with signs and symptoms of a stroke, there are certain criteria that have to be met in order to continue with anticoagulant therapy.  Other conditions in which anticoagulant therapy is used may include coronary occlusion, phlebothrombosis and pulmonary embolism.  Also, anticoagulants are administered prophylactically when major surgery is scheduled for a patient with a history of arterial insufficiencies or other related diagnosis that would warrant anticoagulant use.  In addition, anticoagulants are also used at times for patients who must be immobilized for an extended period of time; these types of anticoagulants are generally given as injections if patient is immobilized.

Atrial fibrillation is a diagnosis that warrants use of anticoagulant therapy that is seen most often. With the diagnosis of atrial fibrillation, warfarin sodium (Coumadin) therapy will be prescribed for the patient to take by mouth once daily.  Blood will be drawn frequently from the patient to have the PT/INR levels reviewed to keep the dosage of Coumadin adjusted accordingly so the blood level remains in the therapeutic range to minimize the risk of problems if it were to become elevated or fall below normal.  Patients should also be advised to take this medication strictly the way it is prescribed; deviations could result in harm to their health.  Patients on oral anticoagulant therapy should be educated enough about the medication so that they can report to their physician if they experience unusual bleeding or if they begin to bruise easier than normal, as these may be signs of adverse effects.



Anticoagulants are not limited to the ones mentioned above.  A lot of the general population at least over the age of 40 years takes an aspirin every day mainly to prevent their risk of heart attack and stroke.  Aspirin is an “anti-platelet” medication, meaning that it interferes with the platelets in the blood and blocks the formation of clotting substances within the body.  Aspirin tends to also cause fewer bleeding complications; however it may not block the clotting process as well as other anticoagulants.  For more information, consult with your family physician to determine the anticoagulant that is right for you.

Along with anticoagulant therapy, patients should avoid activities that may result in increased contact, especially head injury, such as any contact sports.  Dietary changes may also have to occur if taking warfarin sodium.  Over the counter medications may also cause an interaction with warfarin sodium causing an alteration in the PT/INR levels.  Any alteration in the PT/INR levels can be hazardous.

Every patient situation is unique and equally important; therefore the type and dosage of the anticoagulant that will be prescribed and implemented will be dependent upon the patient situation and the decisions made by the physician.

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