Pharmacologic Therapies in Anticoagulation

Med Clin North Am. 2016 Jul;100(4):695-718. doi: 10.1016/j.mcna.2016.03.007.

Abstract

Anticoagulants are beneficial for prevention and treatment of venous thromboembolism and stroke prevention in atrial fibrillation. The development of target-specific oral anticoagulants is changing the landscape of anticoagulation therapy and created growing interest on this subject. Understanding the pharmacology of different anticoagulants is the first step to adequately treat patients with best available therapy while avoiding serious bleeding complications. This article reviews the pharmacology of the main anticoagulant classes (vitamin K antagonists, direct oral anticoagulants, and heparins) and their clinical indications based on evidence-based data currently available in the literature.

Keywords: Anticoagulation; Atrial fibrillation; Direct oral anticoagulants; Heparin; Venous thromboembolism; Warfarin.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Anticoagulants / economics
  • Anticoagulants / pharmacology*
  • Antithrombins / pharmacology
  • Antithrombins / therapeutic use
  • Arthroplasty, Replacement / adverse effects
  • Atrial Fibrillation / complications*
  • Comorbidity
  • Critical Illness
  • Drug Interactions
  • Drug Monitoring
  • Hemorrhage / prevention & control
  • Heparin / pharmacology
  • Heparin / therapeutic use
  • Humans
  • Neoplasms / complications
  • Perioperative Care / methods
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / prevention & control
  • Stroke / etiology*
  • Stroke / prevention & control*
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / prevention & control*
  • Vitamin K / antagonists & inhibitors

Substances

  • Anticoagulants
  • Antithrombins
  • Vitamin K
  • Heparin