5.1.1 Drugs That Affect Coagulation

Drugs That Affect Coagulation

Learning Outcomes

Be able to:

  • Explain the cellular mechanism of action of the different classes of anticoagulants, thrombolytics and antiplatelet drugs
  • Describe the major adverse effects, contraindications and important diet/drug interactions associated with anticoagulants, thrombolytics and antiplatelet drugs
  • Explain the importance of drug monitoring when using warfarin, and outline the role of the INR in patient management
  • Outline the therapeutic rationale for the use of these drugs in the treatment and prevention of acute coronary syndromes, stroke, transient ischemia attack and venous thromboembolism
  • Name the other classes of drugs used in the general management of acute coronary syndrome (myocardial infarction and unstable angina).

Introduction

Inappropriate activation of the coagulation pathways is linked to considerable morbidity and mortality.  The risk of thrombosis increases with age, and each year, coronary heart disease and stroke claim thousands of lives. Additionally, numerous individuals are diagnosed with conditions such as deep vein thrombosis, pulmonary embolism, transient ischemic attacks, and other non-fatal thrombotic events. Thrombosis in an intact vessel typically arises from local trauma, vascular stasis, and systemic changes in blood coagulation.

There are three (3) major classes of drugs used to manage conditions associated with thrombosis.  These are:

1. Anticoagulants (including Indirect Parenteral Anticoagulants, Direct Thrombin Inhibitors, Direct Factor Xa Inhibitors and Vitamin K Antagonists). 

2. Antiplatelets.

3. Thrombolytics or Fibrinolytics.

The figure below shows the sites of action of these drug classes interacting with the coagulation cascade and the fibrinolytic and platelet activation pathways.

📺 Watch the brief vodcast on the introduction of antithrombotic (11 minutes)

License

PC3300 - Applied Therapeutics and Pharmacy Practice 3 Copyright © by JCU Pharmacy. All Rights Reserved.