- What is an anticoagulant?
A: They are drugs that prevent blood clotting. The formation of clots depends on a complex mechanism that prevents bleeding after suffering damage; however, sometimes the formation of clots can trigger a myocardial infarction, a stroke, or the formation of thrombi within the chambers of the heart, for example. Therefore, these drugs fulfill a fundamental function of preventing both the formation of clots, as well as preventing their growth and/or their dissolution in the event that one has formed.
- Is Adiro also an anticoagulant?
A: no, Adiro belongs to the antiplatelet medications, they prevent blood cells called platelets from clumping together to avoid vascular thrombosis, while anticoagulants such as sintrom, act by preventing the formation of fibrin.
- Are there different types of anticoagulants?
A: yes, the best known is called Sintrom or acenocoumarol, aldocumar or warfarin is also available, these are drugs for oral use that act on vitamin K, necessary for part of the coagulation mechanism to function, they are used for a long time. term to avoid thromboembolic complications.
Another group of drugs for oral use are the so-called direct-acting anticoagulants, for a long time known as new anticoagulants, but they are no longer so new. This group includes dabigatran, rivaroxaban, apixaban and edoxaban, they act by blocking the immune system. anticoagulation at a specific point, which is not related to vitamin K, therefore with a fixed dose of once or twice a day, without the need to carry out hemostasis controls, given that the concentration of the drug in the blood is more predictable and stable.
- When is it indicated to take an anticoagulant?
A: They are indicated preventively in cardiovascular diseases that have a high risk of producing thromboembolic events, such as cardiac arrhythmias: atrial fibrillation and atrial flutter. They are also indicated after a history of thrombosis, such as myocardial infarction, stroke, pulmonary embolism, or deep vein thrombosis. Additionally, they are indicated in patients who have undergone heart surgery with the implantation of a prosthetic valve.
- Does that mean that the cardiologist has found a very serious illness in me?
A: Of the pathologies previously mentioned, not all of them present in a serious way, nor are they indicative that one is suffering from something fatal, it may simply be that it is necessary to prevent the formation of a thrombus.
- How do I know which one I should take?
A: In general, cardiologists currently tend to indicate direct-acting oral anticoagulants for chronic treatment, due to different advantages compared to vitamin K inhibitors, while these are a mandatory indication in patients with mechanical valve prostheses, where they are not effective. those of direct action.
- What precautions should I take when taking an anticoagulant?
A series of recommendations are discussed below that are important to take into account: – They should always be taken at the same time to avoid forgetting. – You should take the dose indicated by your doctor, you should not change it on your own, as there is a risk of bleeding or the appearance of a thrombus. – If you forget a dose, take it as soon as possible and if you realize the next day, take your usual dose, do not double the dose, the ideal is to avoid forgetting. – Care must be taken when taking other medications that can increase the action of anticoagulants, such as anti-inflammatories, acetyl-salicylic acid and its derivatives. – If you take vitamin K inhibitors, it will be necessary to perform a blood test called INR, and depending on the result, your doctor will indicate changes in the dose, while with direct-acting inhibitors the INR is not necessary, but an analysis is necessary. at least once a year, to monitor kidney function and decide to change the dose. – Avoid alcoholic beverages. – Deep injections such as intramuscular injections are prohibited. – Always consult your doctor one week in advance before any surgery, dental extraction or any invasive test (such as colonoscopy, endoscopy, biopsy). – If minor bleeding, bruising, or dark stools appear, consult your doctor as soon as possible. If the bleeding is abundant, you should go to the emergency room. –In case of sudden onset of gait disorders, speech disorders, intense headache, vision disorders, you will also go to the emergency room. If pregnancy is suspected, a medical evaluation will be requested.
- How long will I have to take this medication?
A: the usual indication is chronic, in some pathologies and depending on the evolution, your doctor could make the decision to suspend the medication, but it is a decision that requires mandatory medical evaluation, in no case is it the patient's own decision. , since it can involve a high risk.
- What should I do if I am taking a blood thinner and have surgery scheduled?
A: You should contact the doctor in charge of your anticoagulation, one week in advance so that he can give you the guidelines to follow. The regimen varies depending on the anticoagulant you are taking, whether it is direct-acting or a vitamin K inhibitor.
- Can I stop taking this medication on my own?
A: It is not recommended under any circumstances to suspend medication without consulting with your doctor in charge of anticoagulation; at all times a medical evaluation will be necessary to decide to suspend said medication.
By Dr. Jefferson Salas , cardiologist at Quironsalud Sur Hospital
If you are taking anticoagulants for an arrhythmia, the Arrhythmia Unit at UICAR will monitor your case.