Anticoagulants

Anticoagulants, blood thinner, also known in medicine as Anticoagulation known to counteract blood clotting. The drugs are used to prevent vascular occlusion. Various anticoagulants are also suitable for dissolving blood clots.

What are anticoagulants?

Anticoagulants are a group of drugs that prevent the blood from clumping by reducing this "clotting process". Due to the two different mechanisms of action, two technical terms are used for anticoagulants:

1) anticoagulants: The effect takes place on proteins in the liquid Blood percentage (blood plasma)

2) antiplatelet agents: The effect takes place on the Surface of blood platelets (thrombocytes)

Some scientists reject the conceptual separation of the two classes and regard platelet aggregation inhibitors only as a subgroup of anticoagulants. This makes sense because the resulting effect is the same: Both ultimately prevent the formation of blood clots ("thrombi") in the vessels.

Popular is therefore also of Blood thinners the speech. This term is not entirely correct, but it always means the same as the term anticoagulant.

Application, effect & use

Anticoagulants are mostly used in the prevention of various circulatory diseases. The medication is intended to avoid the formation of thrombi and embolisms (vascular occlusions) in risk patients. The focus is on heart attacks and strokes as well as pulmonary embolisms.

People with arteriosclerosis belong to the endangered group because the vascular deposits can trigger blood clotting. A second indication is cardiac arrhythmias, especially atrial fibrillation. The tendency to coagulate results in this clinical picture on a "blood pool" in the antechamber. Strokes occur more frequently without taking anticoagulants.

Angina pectoris is also an area of ​​application for anticoagulants, which must also be given after a myocardial infarction. People with a genetically increased tendency to clot should also take anticoagulants. Anticoagulants are also mandatory medication after surgery if the patient is bedridden for a long time.

Heparins are anticoagulants that are even suitable for dissolving an acute thrombus. These drugs are an important emergency intervention for heart attacks and other embolisms as well as vasoconstriction. Heparins can only be administered as an infusion.

Blood coagulation must also be prevented in blood products or in blood samples. Furthermore, the apparatus-based treatment of the blood requires countermeasures for thrombus formation. This applies to blood washing (dialysis) and the “extracorporeal circulation” (heart-lung machine). The use of anticoagulants is also essential here.

Herbal, natural & pharmaceutical anticoagulants

Anticoagulants start at different points in the coagulation process. Coagulation (blood clotting) is a complex biochemical chain reaction in which several proteins as well as vitamin K and calcium are involved. Coumarins are herbal ingredients that block the effect of vitamin K. The well-known Marcumar belongs to this group of anticoagulants, the model of which is an ingredient of the woodruff and is synthetically produced in a modified form.

Other anticoagulants bind calcium and thus interrupt the blood clotting chain reaction. This includes, for example, citrate (the salt of citric acid), which is used in dialysis.

Some anticoagulants are active ingredients from animal metabolism. Hirudin used to be obtained from leeches ("Hirudo"), but is now produced using genetic engineering. Doctors apply the protein parenterally (infusion), the effect consists in blocking the coagulation factor thrombin. The intestine cannot absorb heparins either, which is why it is only given by injection or infusion.

Pharmaceutical manufacturers still extract the sugar-like substances from pig intestines. Heparins block various coagulation factors from the group of antithrombins. Other fully synthetic anticoagulants affect other plasma factors that are involved in blood clotting.

An anti-platelet agent is aspirin. The drug prevents the platelets from sticking together and is based on a model in the plant kingdom. Salicin is a substance found in willow bark (Salix: Latin: "willow"). The synthetically manufactured preparations contain acetylsalicylic acid and are also anticoagulants.

Risks & side effects

Anticoagulants also suppress the physiologically important wound closure. Even the smallest injuries carry the risk of bleeding that is difficult to stop, and this effect is particularly critical in accidents.

Because of the risk of bleeding, anticoagulants must be discontinued before surgery. On the other hand, overdosing can lead to internal bleeding. Coumarins have a mildly damaging effect on the liver, while heparins can reduce the formation of platelets.

Aspirin, if used in excess, is responsible for stomach ulcers and even gastric perforations. Kidney and liver damage are also possible consequences of the medication. Rare side effects are numerous in the entire spectrum of anticoagulants and are reflected in the instruction leaflets for anticoagulants.