Anti coagulatants

Presented by:- Mr.Gorishankar

Nursing Tutor{tantia university}
Classification
 1. Anticoagulants used in-vivo:
a. Fast acting: Heparin,
heparinoids-heparan sulphate, dextran
sulphate.
b. Slow acting: Oral anticoagulants,
warfarin, dicoumarol,
nicoumalone,phenindione.
 2. Anticoagulants used in-vitro:
Heparin, citrates, oxalates and sodium
edetate.
Types
 1. Oral Anticoagulants: Oral anticoagulants inhibit synthesis of clotting factors
VII, IX and X thereby, clotting is inhibited.
Drugs commonly used:
a.Warfarin sodium
b. Dicoumarol
Uses:
a.Mainly used to slow down or prevent extension of blood clots.
b.Use caution while giving any medication by IM route.
c.Monitor for hematuria, epistaxis, ecchymosis and haematoma.
 2.Parenteral anticoagulants: Heparin acts as an in-vitro anticoagulant by
accelerating the rate of antithrombin
 3.(ATII )binding to thrombin (thrombin is required for converting fibrinogen to
fibrin). It is usefulin all those conditions where oral anticoagulants are used. It
is specifically used for short-termemergency treatment such as during
hemodialysis, myocardial infarction and after CABG surgery.
MODE OF ACTION
Heparin is found in the mast cells of the liver, lungs
and intestinal mucosa. Heparin is the strongestacid in
the body. Heparin is a powerful anticoagulant that acts
instantaneously both vivo and vitro.Heparin activates
plasma antithrombin, which binds to the clotting
factors and inactivate them.Heparin is not effective
orally. It is given by IV or SC route. It should not be
given IM because it maycause haematomas. When given
intravenously the onset of action is immediate,
reaches peak in 510 minutes and clotting time returns
to normal in 2-4 hrs. Treatment is monitored by the
PartialThromboplastin Time (PTT) (preferable) or
clotting time. Heparin is metabolized by heparinase in
the liver
Indication

 Venous thrombosis and pulmonary embolisms: Anticoagulants prevent

extension of thrombus and recurrence of embolism.
 Postoperative, post-stroke patients, bedridden patients, anticoagulants
prevent venous thrombosis amd pulmonary embolism in such diseases
 Rheumatic valvular disease- anticoagulants prevent embolism.
 Unstable angina - heparin reduces the risk of myocardial infarction in
patients with unstable angina.
 Vascular Surgery, artificial heart valves and haemodialysis anticogulants
prevent thromboembolism.
Thanku for attention