An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. Coagulation is a complex process by which Blood forms Clots It is an important part of Hemostasis (the cessation of blood loss from a damaged vessel whereby Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombotic disorders. Thrombosis is the formation of a blood Clot ( Thrombus) inside a Blood vessel, obstructing the flow of Blood through the Circulatory Some chemical compounds are used in medical equipment, such as test tubes, blood transfusion bags, and renal dialysis equipment. A test tube, also known as a culture tube, sample tube, test flute or flaccid flute, is a piece of Laboratory glassware composed of Blood transfusion is the process of transferring Blood or blood-based products from one person into the Circulatory system of another In Medicine, dialysis (from Greek "dialusis" meaning dissolution "dia" meaning through and "lusis" meaning loosening is primarily They also have military applications, whereby their introduction into the wounds of enemy soldiers will make their treatment significantly more difficult.

Contents 1 As medications 1.1 Vitamin K antagonists 1.1.1 Adverse effects 1.1.2 Available agents 1.2 Heparin and derivative substances 1.2.1 Low molecular weight heparin 1.2.2 Synthetic pentasaccharide inhibitors of factor Xa 1.2.3 Major pharmaceutical Heparin recall due to contamination 1.3 Direct thrombin inhibitors 2 Anticoagulants outside the body 3 See also 4 References

As medications

Anticoagulants are given to people to stop thrombosis (blood clotting inappropriately in the blood vessels). This is useful in primary and secondary prevention of deep vein thrombosis, pulmonary embolism, myocardial infarctions and strokes in those who are predisposed. In Medicine, deep vein thrombosis (also known as deep-vein thrombosis or deep venous thrombosis and usually abbreviated as DVT) is the formation Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain

Vitamin K antagonists

The oral anticoagulants are a class of pharmaceuticals that act by antagonizing the effects of vitamin K. Pharmacology (from Greek grc φάρμακον pharmakon, "drug" and grc -λογία -logia) is the study of how Drugs Vitamin K (K from "Koagulations-Vitamin" in German Danish Swedish and Norwegian denotes a group of Lipophilic, Hydrophobic Vitamins that Examples include warfarin. Warfarin (also known under the brand names Coumadin, Jantoven, Marevan, and Waran) is an Anticoagulant. It is important to note that they take at least 48 to 72 hours for the anticoagulant effect to develop fully. In cases when any immediate effect is required, heparin must be given concomitantly. Heparin, a highly-sulfated Glycosaminoglycan, is widely used as an injectable Anticoagulant and has the highest negative Charge density of any known Generally, these anticoagulants are used to treat patients with deep-vein thrombosis (DVT), pulmonary embolism (PE), atrial fibrillation (AF), and mechanical prosthetic heart valves. In Medicine, deep vein thrombosis (also known as deep-vein thrombosis or deep venous thrombosis and usually abbreviated as DVT) is the formation Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein Atrial fibrillation ( AF or afib) is a Cardiac arrhythmia (abnormal heart rhythm that involves the two upper chambers ( atria) of the Heart An artificial heart valve is a device which is implanted in the heart of patients who suffer from valvular diseases in their heart

Adverse effects

Patients aged 80 years or more may be especially susceptible to bleeding complications with a rate of 13 bleeds per 100 person-years. ^[1]

These oral anticoagulants are used widely as poisons for mammalian pests, especially rodents. Rodentia is an order of Mammals also known as rodents, characterised by two continuously-growing incisors in the upper and lower jaws which must (For details, see rodenticide and warfarin. Rodenticides are a category of Pest control Chemicals intended to kill Rodents Single feed baits are chemicals sufficiently Warfarin (also known under the brand names Coumadin, Jantoven, Marevan, and Waran) is an Anticoagulant. )

Available agents

• Warfarin (Coumadin) This is the main agent used in the U. Warfarin (also known under the brand names Coumadin, Jantoven, Marevan, and Waran) is an Anticoagulant. S. and UK^[2]
• Acenocoumarol and phenprocoumon This is used more commonly outside the U. Acenocoumarol is an Anticoagulant that functions as a Vitamin K antagonist (like Warfarin) Phenprocoumon (marketed under the brand names Marcoumar, Marcumar and Falithrom) is an Anticoagulant drug a derivative of Coumarin S. and the UK
• Brodifacoum Rat poison, not used medically
• Phenindione

Heparin and derivative substances

Heparin is a biological substance, usually made from pig intestines. Toxicology Brodifacoum has a similar mode of action to Warfarin. Phenindione is an Anticoagulant which functions as a Vitamin K antagonist Heparin, a highly-sulfated Glycosaminoglycan, is widely used as an injectable Anticoagulant and has the highest negative Charge density of any known Pigs, also called hogs or' swine', are Ungulates which have been domesticated as sources of food leather and similar products since ancient times It works by activating antithrombin III, which blocks thrombin from clotting blood. Antithrombin (AT is a small protein molecule that inactivates several enzymes of the Coagulation system Heparin can be used in vivo (by injection), and also in vitro to prevent blood or plasma clotting in or on medical devices. In vivo ( Latin: within the living means that which takes place inside an organism. In vitro ( Latin: within the glass refers to the technique of performing a given experiment in a controlled environment outside of a living Organism Vacutainer brand test tubes containing heparin are usually colored green.

Low molecular weight heparin

Low molecular weight heparin is a more highly processed product that is useful as it does not require monitoring of the APTT coagulation parameter (it has more predictable plasma levels) and has fewer side effects. In Medicine, low-molecular-weight heparin ( LMWH) is a class of Medication used as an Anticoagulant in diseases that feature Thrombosis The partial thromboplastin time' (PTT or activated partial thromboplastin time ( aPTT or APTT) is a performance indicator measuring the efficacy of both the "intrinsic" Coagulation is a complex process by which Blood forms Clots It is an important part of Hemostasis (the cessation of blood loss from a damaged vessel whereby

Synthetic pentasaccharide inhibitors of factor Xa

• Fondaparinux is a synthetic sugar composed of the five sugars (pentasaccharide) in heparin that bind to antithrombin. Fondaparinux (Arixtra is an Anticoagulant medication As shown in the box to the right fondaparinux is a synthetic pentasaccharide It is a smaller molecule than low molecular weight heparin.
• Idraparinux

Major pharmaceutical Heparin recall due to contamination

In March 2008 major recalls of Heparin were announced by pharmaceuticals due to a suspected and unknown contamination of the raw Heparin stock imported from China ^{[3] [4]}. The U. S. Food and Drug Administration was quoted as stating that at least 19 deaths were believed linked to a raw Heparin ingredient imported from the People's Republic of China, and that they had also received 785 reports of serious injuries associated with the drug’s use. According to the New York Times: 'Problems with heparin reported to the agency include difficulty breathing, nausea, vomiting, excessive sweating and rapidly falling blood pressure that in some cases led to life-threatening shock'.

Direct thrombin inhibitors

Main article: direct thrombin inhibitor

Another type of anticoagulant is the direct thrombin inhibitor. Direct thrombin inhibitors (DTIs are a class of Medication that act as Anticoagulants (delaying blood clotting) by directly inhibiting the Enzyme Direct thrombin inhibitors (DTIs are a class of Medication that act as Anticoagulants (delaying blood clotting) by directly inhibiting the Enzyme ^[5] Current members of this class include argatroban, lepirudin, and bivalirudin. Argatroban is an Anticoagulant that is a small molecule Direct thrombin inhibitor. Lepirudin ( Refludan) is an Anticoagulant which functions as a Direct thrombin inhibitor. Bivalirudin ( Angiomax) is a drug that belongs to the Anticoagulant class and acts as a Direct thrombin inhibitor. An oral direct thrombin inhibitor, ximelagatran (Exanta) was denied approval by the Food and Drug Administration (FDA) in September 2004 [1] and was pulled from the market entirely in February 2006 after reports of severe liver damage and heart attacks. Ximelagatran ( Exanta or Exarta, H 376/95 is an Anticoagulant that has been investigated extensively as a replacement for Warfarin that would [2]

Anticoagulants outside the body

Laboratory instruments, test tubes, blood transfusion bags, and medical and surgical equipment will get clogged up and become nonoperational if blood is allowed to clot. A medical laboratory or clinical laboratory is a Laboratory where tests are done on clinical specimens in order to get information about the Health Chemicals can be added to stop blood clotting. Apart from heparin, most of these chemicals work by binding calcium ions, preventing the coagulation proteins from using them. Chelation is the binding or complexation of a bi- or multidentate Ligand. Calcium (ˈkælsiəm is the Chemical element with the symbol Ca and Atomic number 20 Coagulation is a complex process by which Blood forms Clots It is an important part of Hemostasis (the cessation of blood loss from a damaged vessel whereby

• EDTA is denoted by mauve or purple caps on Vacutainer brand test tubes. EDTA is a widely used abbreviation for the Chemical compound ethylenediaminetetraacetic acid (and many other names see table This chemical strongly and irreversibly binds calcium. It is in a powdered form.
• Citrate is usually in blue Vacutainer tube. A citrate can refer either to the Conjugate base of Citric acid, (C3H5O(COO33&minus or to the Esters of citric It is in liquid form in the tube and is used for coagulation tests, as well as in blood transfusion bags. It gets rid of the calcium, but not as strongly as EDTA. Correct proportion of this anticoagulant to blood is crucial because of the dilution. It can be in the form of sodium citrate or ACD. Sodium citrate usually refers to Trisodium citrate, though it can refer to any of the sodium Salts of Citric acid: Monosodium citrate Acid Citrate Dextrose Solution (sometimes called Anticoagulant Citrate Dextrose Solution is a solution of Citric acid, Sodium citrate and Dextrose in water
• Oxalate has a similar mechanism to citrate. An oxalate (also ethanedioate) is a salt or Ester of Oxalic acid. It is the anticoagulant used in fluoride (grey top) tubes. Fluoride is the reduced form of Fluorine. Both organic and Inorganic compounds containing the element fluorine are considered fluorides

For the meaning of more colors, see Vacutainer#including coagulants. Vacutainer is a registered brand of Test tube specifically designed for Venipuncture.

See also

• Anticoagulation in pregnancy

References

1. ^ Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S (2007). Anticoagulation in pregnancy is an issue that occurs in women who are at risk for clot formation and subsequently become pregnant. "Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation". Circulation 115 (21): 2689-96. doi:10.1161/CIRCULATIONAHA.106.653048. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17515465.  
2. ^ Ron Winslow; Avery Johnson. "Race Is on for the Next Blood Thinner", Wall Street Journal, 2007-12-10, p. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1041 - Empress Zoe of Byzantium elevates her adoptive son to the throne of the Eastern Roman Empire as Michael V  A12. Retrieved on 2008-01-06. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1066 - Harold Godwinson is crowned King of England. 1205 - Philip of Swabia becomes King  ". . . in a market now dominated by one of the oldest mainstay pills in medicine: the blood thinner warfarin. At least five next-generation blood thinners are in advanced testing to treat or prevent potentially debilitating or life-threatening blood clots in surgery and heart patients. First candidates could reach the market in 2009. " 
3. ^ New York Times, March 6, 2008, Drug Tied to China Had Contaminant, F. D. A. Says, retrieved 2008-03-07
4. ^ New York Times, March 7, 2008, German Authorities Report Problems With Blood Thinner, retrieved 2008-03-07
5. ^ Di Nisio M, Middeldorp S, Büller HR (2005). "Direct thrombin inhibitors". N. Engl. J. Med. 353 (10): 1028-40. doi:10.1056/NEJMra044440. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 16148288.  

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