Anticoagulant treatment
Anticoagulants are the treatment of choice for venous thromboembolic disease. They are also used in patients with a heart arrhythmia or heart condition that predisposes them to having a systemic embolism (formation of a clot or thrombus that travels from the heart to any blood vessel in the body) or from the heart to the veins in the brain causing a stroke.
Anticoagulants are medication that modify blood clotting so that a thrombus or clot does not form inside the blood vessels. The main effect is to slow the blood’s clotting time.
There are different types of anticoagulants: injectable or oral.
Injectable
Low molecular weight or unfractionated heparin. Should be started at therapeutic doses as soon as thrombosis is suspected, even before the diagnosis is confirmed, or as prophylaxis (prevention), at prophylactic doses, when the person has one or more risk factors that could trigger a venous thromboembolism (such as hip or knee replacement surgery). They are administered at fixed doses according to the patient’s weight, the type of thrombosis being treated or risk factor being controlled.
They are used as maintenance therapy when oral anticoagulants are contraindicated (e.g. pregnancy) or have been ineffective.
Oral
They are used as maintenance treatment (longer use) and are given on confirmation of the diagnosis of deep vein thrombosis or pulmonary embolism. There are two types of oral anticoagulants: vitamin K antagonists and direct-acting.
The anticoagulant treatment is controlled with blood tests or capillary blood tests (by pricking the patient's finger). Monitoring of patients on anticoagulant treatment is done by haematology and haemotherapy specialists.