Anticoagulants Overview Flashcards

Introduction to Anticoagulants

• Anticoagulants are a subclass of coagulation modifier drugs that prevent clot formation.
• Other subclasses include antiplatelets, thrombolytics, antifibrinolytics, and reversal drugs.
• Focus on indications, safety considerations, and common anticoagulation drugs.

Anticoagulant Subclasses

• Enoxaparin is classified as a low-molecular-weight heparin (LMWH).
• Clopidogrel is an antiplatelet drug, not an anticoagulant.
• Warfarin is an anticoagulant but does not fall under heparins.
• Rivaroxaban acts as a selective factor Xa inhibitor, also classified as an anticoagulant.

About Anticoagulants

• Anticoagulants include heparins, LMWHs, direct thrombin inhibitors, and factor Xa inhibitors.
• They prevent clot formation by inhibiting specific clotting factors in the coagulation cascade.
• Known as antithrombotic drugs, they decrease coagulability and are used to prevent or treat thrombosis and emboli.
• Conditions treated include myocardial infarction (MI), stroke, pulmonary embolism, and deep vein thrombosis (DVT).
• Anticoagulants do not dissolve pre-formed thrombi; they act at various points in the coagulation cascade.

Anticoagulant Indications for Use

• Prescribed for prevention of thrombus formation in high-risk situations such as:
  • Myocardial infarction and unstable angina
  • Atrial fibrillation
  • Mechanical heart valves and conditions causing blood stagnation
  • Major orthopedic surgery and prolonged immobility
• Effective in the prevention and treatment of DVT or pulmonary embolism, excluding betrixaban, which is only for prophylaxis.

Safety Considerations for Anticoagulants

• Anticoagulants pose a high risk for adverse drug reactions and bleeding complications.
• Excessive bleeding can occur if these drugs overshoot their intended effect.
• Risk of bleeding increases with dosage; careful monitoring is crucial.
• Contraindications include:
  • Acute bleeding situations or high bleeding risk conditions (e.g., coagulation disorders, recent surgeries)
  • Pregnancy, particularly contraindicated with warfarin (category X).
  • Risk of epidural hematoma in patients with indwelling epidural catheters.
• Common adverse effects include bleeding (localized or systemic), GI upset (nausea, vomiting), and thrombocytopenia.
• Each subclass of anticoagulants has unique mechanisms of action and safety profiles.