1. Blood/Blood Formation
henderson

2. Blood Clotting Series of events in order to form a blood clot
Our body performs a brilliant balancing act between bleeding and clotting
Three things must happen:
Trauma
Bleeding
Clotting
A blood clot is another name for Thrombus.

3. About Blood Clots “Economy class syndrome” Brain- Stroke
Clots in legs
Brain- Stroke
Atrial fibrillation- Stroke
Irregular heart beats

4. What are anti-coagulants
A substance that hinders the clotting of blood.
These are sometimes called blood thinners…which somewhat a misconception.
Used for treatment of:
DVT
Pulmonary Embolism
Atrial Fibrillation
Brand
Generic
Coumadin
Warfarin
Lovenox
Enoxaparin
Pradaxa
Dabigatran Exenlate

5. Warfarin-Coumadin 1948- identified for rodents
1954- approved for human use

6. What interacts with warfarin
Antibiotics
Vitamin K or leafy greens (Mephyton, or Phytonadione)
NSAIDs
Advil
Aleve
Motrin
INCREASES BLEEDING

7. Pros and Cons of Warfarin
Able to monitor
Lots of experience
Antidote
Cheap
Effective
Few side effects
CONS
Need to monitor
Drug interactions
bleeding
Care with surgery

8. Antithrombotic Agents
Used to decrease platelet aggregation (stickiness) and to decrease unwanted clot formation (heart attack prevention)
Brand
Generic
Aspirin
Plavix
Clopidogrel
Persantine
Dipyridamole

9. Aspirin Lots of different kinds of aspirin Heart attack Stroke
Low dose
Labeled for women
Heart attack
Stroke
Cardiac stent

10. Who shouldn’t take aspirin?
History of bleeding
On other anti-coagulant medications
Not intended for venous clots like our patient with DVT

11. INR Measures how well the warfarin is working
International Normalized Ratio

12. Thrombolytic Agents Dissolve the clot
Dosage form depends on the severity of the blood clot. IV would be for immediate action. Oral would be for long term treatment of blood clotting.
Symptoms of a stroke
Weakness
Facial drooping
balance

13. New Anticoagulants
Eliquis
Xarelto
Very expensive

14. PROs and CONs of these NEW drugs
No monitoring
Fewer interactions
Effective and for some, better than warfarin
CONS
EXPENSIVE
Unable to measure
No antidote
Twice daily

15. Hemorrheologic Agents
Used to treat intermittent claudication (severe and painful cramping in the legs) by decreasing blood viscosity to help it circulate to areas of need.
Brand
Generic
Trental
Pentoxyfylline