The American Heart Association defines anticoagulants as medications that delay blood clotting. There are two common anticoagulants, warfarin (Coumadin) and heparin. Anticoagulants are often referred to as blood thinners, though they do not actually work by thinning the blood. Anticoagulants are prescribed to patients with health conditions that have the potential for clotting such as atherosclerosis (a disease in which plaque builds in the arteries). Blood clots can lead to stroke or embolisms, which are both life-threatening conditions.
Considerations
Heparin is usually started in a hospital setting to deal with potentially life-threatening clots in the lungs, heart or blood vessels. It is also used in many types of surgeries, kidney dialysis and blood transfusions. Heparin is taken intravenously or injected under the skin. Most patients who need long-term anticoagulant therapy will be slowly titrated off of heparin for the more user-friendly warfarin (Coumadin). Warfarin is a tablet taken once a day by mouth, and it must be taken exactly as directed.
Precautions
The National Institute of Health advises patients never to take two or more medications that contain Coumadin at the same time. Make sure your health-care provider is aware of all medications, including vitamins and herbal supplements. It is especially important to note usage of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. If you are going to take any kind of injection such as a flu shot or immunization, alert the clinician that you are taking warfarin, as it might take longer to stop bleeding.
Side Effects
Warfarin side effects can include gas, fatigue, pale skin, hair loss, feeling cold and chills. Heparin side effects occur less often but include abdominal or stomach pain, bleeding gums, blood in stool or urine, joint pain, stiffness, easy bruising and vomiting of coffee ground like material. If any of these occur, contact your health care professional immediately.
Monitoring Therapy
To monitor for a therapeutic level of the drug, patients will have regular labs drawn. Physicians use three types of labs, Prothrombin Time (PT), Partial Thromboplastin Time (PTT) and International Normalized Ratio (INR). According to Lab Tests Online, PT evaluates the ability of the blood to clot normally and is often used in conjunction with the PTT to monitor the effect of anticoagulant therapy. Physicians use the INR to evaluate current treatment and help titrate the drug to maintain a therapeutic level.
Anticoagulation Clinics
Many hospitals now offer anticoagulation clinics. The Cleveland Clinic explains that anticoagulation clinics were established to monitor and manage a patient's anticoagulant regimen. In the clinic, a finger stick will be performed to assess the patient's current INR level. A pharmacist will then review the results and determine if changes need to be made in the current medication. Anticoagulation therapy can be dangerous if not monitored properly, and clinics provide the safety and convenience of being able to allow additional medications immediately in the event of serious complications.
Member Comments