Anticoagulation therapy is used to prevent blood clots in a variety of patients including those with heart defects, a history of blood clots, medically implanted devices and heart arrhythmia. The most common forms of anticoagulation medication include aspirin, warfarin and heparin. These medication thin the blood or interfere with natural clotting processes. Patients undergoing anticoagulation therpay require close monitoring because of the potential dangers of this therapy. You should not undergo anticoagulation therapy without the guidance of a physician.
Bleeding
Your body's natural clotting mechanisms exist to help stop bleeding. Therefore, one of the most common dangers of anticoagulation medications, like warfarin -- typically sold under the brand name Coumadin -- is a hemorrhage and uncontrolled bleeding. The incidence of bleeding increases with the intensity of anticoagulation and it is therefore imperative that your physician monitor your level of anticoagulation and keep it in a safe range. This is done by performing blood tests. Aspirin causes fewer bleeding complications than warfarin and heparin, but does not provide sufficient anticoagulation for many patients. A newer medication called clopidogrel, which is sold under the brand name Plavix, has shown promise by providing adequate anticoagulation with less complications involving bleeding.
Drug Interactions
Warfarin interacts with many other medications and foods, either directly or because both are broken down by the same enzymes. Drugs that interact with warfarin include barbituates, salicylates, Bactrim and vitamin E. These interactions can enhance the dangers of warfarin as well as other drugs. Therefore it is imperative to inform your physician about your anticoagulation therapy before you start any new medications or major dietary changes.
Pregnancy
Anticoagulation therapy poses special risks to women who are pregnant or trying to get pregnant. Warfarin poses potential dangers to the fetus, especially during the first trimester. For this reason many pregnant women switch to heparin during the first week of pregnancy. Discussing anticoagulation options with your obstetrician can help avoid potential harm to the fetus.
Prevention
You can take several measures to avoid the dangers of anticoagulation. The first step is to take medication exactly as prescribed and to alert your physician of any discomfort or side effects you experience. If you are having dental work done, tell your dentist about your anticoagulation as this affects the types of procedures you can undergo. Do not mix medications like warfarin and aspirin without explicit instructions from your physician and ask about foods you should avoid while taking anticoagulation medications.
References
- American Heart Association: Anticoagulation
- "American Family Physician"; Warfarin Therapy: Evolving Strategies in Anticoagulation; J. Hartman and B. Bushwick; February 1999
- "Thrombosis and Haemostasis"; Bleeding With Anticoagulation Therapy; G. Palareti and B. Cosmi; August 2009
- National Patient Safety Agency: Actions that can make Anticoagulation Therapy Safer
- MayoClinic.com; Warfarin: Any Harm in Long-Term Use?; Martha Grogan, M.D.; March 17, 2011
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