Anticoagulants

Drug class
Class identifiers
ATC code	B01
External links
MeSH	D00534-class

Anticoagulants are a class of drugs that work to prevent blood coagulation (clotting). Such substances occur naturally in leeches and blood-sucking insects. A group of pharmaceuticals called anticoagulants can be used as an injection as a medication for thrombotic disorders. Oral anticoagulants are also available. Some anticoagulants are used in medical equipment, such as test tubes, blood transfusion bags, and renal dialysis equipment.

Anticoagulants are closely related to antiplatelet drugs and thrombolytic drugs by manipulating the various pathways of blood coagulation. Specifically, anticoagulants manipulate the coagulation cascade that builds upon the initial platelet thrombus.

The use of anticoagulants is a decision based upon the risks and benefits of anticoagulation. The biggest risk of anticoagulation therapy is the increased risk of bleeding. In otherwise healthy people, the increased risk of bleeding is minimal, but those who have had recent surgery, cerebral aneurysms, and other conditions may have too great of risk of bleeding. Generally, the benefit of anticoagulation is prevention of or reduction of progression of a disease. Some indications for anticoagulant therapy that are known to have benefit from therapy include:

In these cases, anticoagulation therapy can prevent formation of dangerous clots or prevent growth of clots.

The decision to begin therapeutic anticoagulation often involves the use of multiple bleeding risk predictable outcome tools as non-invasive pre-test stratifications due to the potential for bleeds while on blood thinning agents. Among these tools are HAS-BLED,ATRIA, and CHA2DS2-VASc.

Patients aged 80 years or more may be especially susceptible to bleeding complications, with a rate of 13 bleeds per 100 person-years. Depletion of vitamin K by coumarin therapy increases risk of arterial calcification and heart valve calcification, especially if too much vitamin D is present.

Foods and food supplements with blood-thinning effects include nattokinase, lumbrokinase, beer, bilberry, celery, cranberries, fish oil, garlic, ginger, ginkgo, ginseng, green tea, horse chestnut, licorice, niacin, onion, papaya, pomegranate, red clover, soybean, St. John’s wort, turmeric, wheatgrass, and willow bark. Many herbal supplements have blood-thinning properties, such as danshen and feverfew. Multivitamins that do not interact with clotting are available for patients on anticoagulants.

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