Anticoagulants are used to treat several conditions including heart failure, deep venous thrombosis, acute coronary syndrome, and catheter patency. Heparin is given via IV injection and works by inactivating factor Xa and inhibiting the conversion of prothrombin to thrombin. At high doses, it also inactivates factors IX, X, XI, and thrombin and inhibits the conversion of fibrinogen to fibrin. Warfarin is administered orally and takes 2-3 days for its full anticoagulant effect. It is metabolized in the liver and interferes with hepatic synthesis of vitamin K, depleting vitamin K reserves and reducing the synthesis of active clotting factors.

1. Anticoagulants
How it works
Reference
Medical pharmacology at a glance
&
Medscape

2. Indications:
1. Heart failure
2. Deep venous thrombosis as a prophylaxis
3. Acute coronary syndrome
4. Catheter patency

3. To know
The Heart fails to pump blood
Heart failure
• This Patient complains of :
• Shortness of breath ,chest pain , weak speedy pulse ,fatigue , increase urination at night,
• Weight loss, cyanosis
Clinical symptoms mainly due to rupture of atherosclerotic plaque or complet
thrombosis of infract related artery
Acute coronary syndrome
• This patient complains of :
• Palpitations, chest pain, hypotension ,cardiac shock

4. 1- Heparin
• Naturally occurring
• Highly acidic glycosaminoglycan
• Is given as IV injection
• Metabolized in liver and RES
• Eliminated in urine
❖ It inactivates factor Xa and inhibits
conversion of prothrombin to
thrombin
❖At high dose : it inactivates factors ǀX
,X , Xǀ and thrombin and inhibits
conversion of fibrinogen into fibrin

5. 2-warfarin
• Vit K antagonist
• Oral administration
• Full anticoagulant effect is delayed for 2-3
days
• Metabolized in liver
• Eliminated after half life (patient specific)
❖Interfere with hepatic synthesis of vit K
❖Depletes functional vit K reserves which in
turn reduces synthesis of active clotting
factors

6. Thanks