What is the difference between anticoagulant and antithrombotic

There are four oral anticoagulants available in Hong Kong, including the traditional drug warfarin, and the newer drugs dabigatran etexilate, apixaban, and rivaroxaban. Anticoagulants are considered more aggressive drugs than antiplatelet drugs. They are recommended primarily for people with a high risk of stroke and people with atrial fibrillation a heart condition that causes a irregular heart rate.

Other people with blood that clots easily, such as those who have deep vein thrombosis blood clots in the deep veins of the legs or pulmonary embolism a blood clot in the lungs , may also benefit from anticoagulant therapy. All registered antiplatelet drugs in Hong Kong are prescription-only medicines except aspirin.

Low-dose aspirin is the most commonly used antiplatelet drug. Examples of other oral antiplatelet drugs include clopidogrel, ticlopidine, dipyridamole, prasugrel, and ticagrelor. Low-dose aspirin is highly recommended for preventing a first stroke, but it and other antiplatelet drugs also have an important role in preventing recurrent strokes. Antiplatelet drugs may also be given if you have had acute coronary syndrome heart attack or unstable angina or a coronary stent.

Anticoagulants and antiplatelet drugs can be classified according to their mechanism of action. Anticoagulants Anticoagulants interfere with various clotting factors in the coagulation process to slow down the process. Oral anticoagulants can be classified as follows: 1. Vitamin K antagonists: Inhibit the activation of the vitamin K-dependent clotting factors. The degree of depression of clotting factors is dose-dependent. The only vitamin K antagonist available in Hong Kong is warfarin. Direct thrombin inhibitors DTIs : Bind with thrombin which is the central effector of coagulation to inactivate thrombin.

Example includes dabigatran etexilate. Direct factor Xa inhibitors: Bind to clotting factor Xa specifically to block its activity. Examples include apixaban and rivaroxaban. Antiplatelet Drugs Antiplatelet drugs describe agents which decrease platelet aggregation and inhibit thrombus clot formation. Platelet activation process involves the production of several platelet activation agonists including thrombin, thromboxane A2 TXA2 and adenosine diphosphate ADP , which amplify the platelet response and stimulate platelet aggregation.

Oral antiplatelet drugs can be classified as follows: 1. COX-1 inhibitor: Potent antiplatelet which inhibits platelet cyclooxygenase COX , a key enzyme in the generation of TXA2 which is responsible for platelet activation and aggregation. The main member of this class is aspirin. Examples include ticlopidine, clopidogrel and prasugrel.

Example includes ticagrelor. Phosphodiesterase inhibitors: Inhibit adenosine uptake and cyclic GMP phosphodiesterase activity, thus decreases platelet aggregability. Phosphodiesterase inhibitor alone has little antiplatelet effect and is currently used in combination with other drugs.

Example includes dipyridamole. When you start taking warfarin as prescribed, tell your doctor about any medications or supplements that you are taking. Lots of herbal medicines and supplements can interact with warfarin. Do not start taking any new herbal medicines or supplements without checking with your doctor. Examples of such herbal medicines and supplements include dong quai, glucosamine, ginkgo biloba, ginseng, St.

If you receive new prescriptions from someone other than your usual medical provider, make sure you remind him that you are taking an anticoagulant or antiplatelet drug as the drugs may interact with each other. Consult your doctor before making any major changes to your diet. The socioeconomic burden of such an organizational model is, however, high and requires continuous resources directed to the implementation of the staff of thrombosis centers to respond to the growing demand arising from the aging of the population at increased thrombotic risk.

The progressive involvement of adequately trained general practitioners working in close collaboration with FCSA Federation of Centers for Diagnosis of Thrombosis and Surveillance of Antithrombotic Therapies centers could be a way to resolve this critical issue, overcoming the current imbalance between patients requiring anticoagulation treatment and caregivers.

For Slovakia, Dr. Stanciakova and colleagues overview the state of anticoagulation therapy in that country, with the focus on DOACs, as also represented by the National Centre of Haemostasis and Thrombosis, which provides the comprehensive care for a substantial group of patients from the Slovak Republic.

They report on the characteristics of their patient population age, sex, family history, results of thrombophilic screening, and indication for the use of anticoagulant therapy , as well as their experience with administration of DOACs in routine clinical practice, their indications in terms of prevention of venous thromboembolism, and results of measurement of their effectiveness and other parameters of the activation of hemostasis.

For Iran, Dr. Dorgalaleh and colleagues explore the use of anticoagulants in that country, where DOACs have an increasingly growing role in the management of thromboembolic complications, although warfarin remains the most widely prescribed anticoagulant in Iran. For France 11 , Dr. Jourdi and colleagues identify that significant changes have been brought to more recent anticoagulant therapeutic and prophylactic strategies in that country.

They advise that health professionals need to be aware of the benefit-risk profiles of DOACs as well as of heparin derivatives and VKAs in order to deal properly with these drugs, making sure that the right patient gets the right anticoagulant therapy at the right time. In this review, the authors briefly overview the anticoagulant drugs available in France in , and then outline different management strategies and suggestions of national expert groups.

For Finland 12 , Dr. Helin and colleagues identify that while DOACs are increasingly used in common indications for anticoagulation, including non-valvular atrial fibrillation, deep vein thrombosis and pulmonary embolism, traditional anticoagulants, either warfarin or heparins are still the primary choice for patients with cardiac valvular replacement, severe thrombophilia, pediatric, pregnant and many cancer patients.

Laboratory monitoring of warfarin and heparins is well established, while under specific emergency conditions DOACs require specific assays, the availability of which may be limited. Finland benefits from centralized laboratory networks, offering harmonized services throughout our rather sparsely populated country.

Interaction, collaboration and continuous education between clinic and laboratory is increasingly needed, under the era of rapid change of traditions in anticoagulation management.

For the United Kingdom 13 , Dr. Mould and colleagues identify that region to be one of the first to implement rigorous thromboprophylaxis measures to reduce the risk of hospital acquired thrombosis.

More recently, with the arrival of DOACs, active screening for atrial fibrillation has been made a priority nationwide. Also, better awareness of the signs and symptoms of venous thromboembolism means patients are getting the best treatment early, thus preventing complications. Despite all these positive efforts, some aspects of anticoagulation therapy have been recently noted to represent problem areas, and are further discussed in this review.

A separate contribution from the United States of America is provided by Robert Gosselin and colleagues Implemented in , the Joint Commission on Accreditation of Healthcare Organizations JCAHO, later known as just Joint Commission implemented required initiatives for accredited institutions that provide health care services for improving patient safety.

The first six National Patient Safety Goals NPSG required these institutions to address and improved the identified short comings associated with patient misidentification, communications between caregivers, use of high-alert medications and drug infusion devices, reduction of surgical errors, and clinical alerts. The purpose of this review is to describe the laboratory and pharmacy department roles addressing the current eight required NPSG elements related to anticoagulation safety.

In a final manuscript related to anticoagulants 16 , McGlasson and Fritsma explore the in vitro detection and removal of DOACs from patient plasma specimens, in cases where laboratory testing may be required and the effects of DOACs mitigated.

Chrystel Barron barronc ccf. Thank you for the clarification and list separating anti-coagulants from anti-platelets. This info. Your email address will not be published. Skip to content Home. Revenue Cycle. Knowing the Difference between Anticoagulants and Antiplatelets. July 12, at am 8. Note Hirsh, Jack.