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Anticoagulants

Definition:

  • Anticoagulants are medications that inhibit blood clot formation, thereby reducing the risk of thromboembolic events such as deep vein thrombosis, pulmonary embolism, and stroke.

  • They are essential in preventing abnormal clotting in various medical conditions.

Mechanism of Action:

  • Vitamin K Antagonists: 

    • Drugs like Warfarin and Anisindione inhibit the enzyme vitamin K epoxide reductase, decreasing the regeneration of active vitamin K.

    • This impairs the synthesis of vitamin K-dependent clotting factors (II, VII, IX, and X), reducing the blood's ability to form clots.

  • Antiplatelet Agents: 

    • Clopidogrel inhibits platelet aggregation by blocking the P2Y₁₂ ADP receptor on platelets, preventing them from clumping together to form clots.

Common Anticoagulant Drugs:

Vitamin K Antagonists:

  • Warfarin

  • Anisindione

Antiplatelet Agents:

  • Clopidogrel

Uses:

  • Preventing and treating thromboembolic disorders (e.g., deep vein thrombosis, pulmonary embolism)

  • Stroke prevention in patients with atrial fibrillation

  • Prophylaxis in individuals with mechanical heart valves

  • Reducing the risk of heart attacks and strokes in patients with coronary artery disease

Side Effects:

Vitamin K Antagonists:

  • Increased risk of bleeding

  • Teratogenic effects (contraindicated in pregnancy)

  • Numerous drug and food interactions affecting vitamin K levels

Antiplatelet Agents:

  • Increased risk of bleeding

  • Gastrointestinal discomfort

  • Rarely, thrombotic thrombocytopenic purpura (TTP)


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