What is the difference between antiplatelet and antithrombotic

Both fibrin and platelets stabilize the thrombus and prevent it from falling apart. Fibrin is the more important component of clots that form in veins, and platelets are the more important component of clots that form in arteries where they can cause heart attacks and strokes by blocking the flow of blood in the heart and brain, respectively, although fibrin plays an important role in arterial thrombosis as well. There are two classes of antithrombotic drugs: anticoagulants and antiplatelet drugs.

Anticoagulants slow down clotting, thereby reducing fibrin formation and preventing clots from forming and growing. Antiplatelet agents prevent platelets from clumping and also prevent clots from forming and growing.

The anticoagulants heparin and dicumarol were discovered by chance, long before we understood how they worked. Heparin was first discovered in by a medical student at The Johns Hopkins University who was investigating a clotting product from extracts of dog liver and heart.

In , dicumarol the precursor to warfarin was extracted by a biochemist at the University of Wisconsin from moldy clover brought to him by a farmer whose prize bull had bled to death after eating the clover. Both of these anticoagulants have been used effectively to prevent clots since These drugs produce a highly variable anticoagulant effect in patients, requiring their effect to be measured by special blood tests and their dose adjusted according to the results.

Heparin acts immediately and is given intravenously through the veins. Warfarin is swallowed in tablet form, but its anticoagulant effect is delayed for days. Therefore, until recently, patients requiring anticoagulants who were admitted to a hospital were started on a heparin infusion and were then discharged from the hospital after five to seven days on warfarin.

LMWH is produced by chemically splitting heparin into one-third of its original size. It has fewer side effects than heparin and produces a more predictable anticoagulant response.

By the mid s, LMWH preparations were being tested in clinical trials, and they have now replaced heparin for most indications. Because LMWH is injected subcutaneously under the skin in a fixed dose without the need for anticoagulant monitoring, patients can now be treated at home instead of at the hospital. With the biotechnology revolution has come genetically engineered "designer" anticoagulant molecules that target specific clotting enzymes.

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Patient Access: Continuing the Path to Compliance. White Papers. Sign up. Already have an account? Log in. If you have some kinds of heart or blood vessel disease, or if you have poor blood flow to your brain, your doctor may recommend that you take a blood thinner.

Blood thinners reduce the risk of heart attack and stroke by reducing the formation of blood clots in your arteries and veins. You may also take a blood thinner if you have an abnormal heart rhythm called atrial fibrillation, heart valve disease, or congenital heart defects. Treatment with blood thinners There are two types of blood thinners — anticoagulants and antiplatelet drugs.

Classification of blood thinners Anticoagulants and antiplatelet drugs can be classified according to their mechanism of action. Common side effects and precautions Drug class Common side effects Precautions Anticoagulants 1. Vitamin K antagonist haemorrhage nausea and vomiting diarrhea jaundice hepatic dysfunction pancreatitis pyrexia alopecia rash Use with caution in mild to moderate renal impairment.

Monitor INR more frequently in severe impairment Not recommended for patients with severe hepatic impairment, or in first trimester of pregnancy Regular blood test to check how long it takes for your blood to clot INR test and dose may need to be adjusted 2.

Direct thrombin inhibitors haemorrhage nausea dyspepsia diarrhoea abdominal pain anaemia Use with caution in the elderly and in patients with low body weight Use with caution in patients with bleeding disorders, thrombocytopenia, recent biopsy or major trauma, oesophagitis, gastritis and oesophageal reflux Use with caution in patients taking concomitant drugs that increase risk of bleeding Not recommended for patients with active bleeding, or at significant risk of major bleeding, or with severe hepatic and renal impairment Not recommended in pregnancy or breastfeeding 3.

COX-1 inhibitor bronchospasm gastro-intestinal irriation such as nausea gastro-intestinal haemorrhage other haemorrhage e. General advice Take warfarin once a day at the same time each day as prescribed, usually in the evening. If you accidentally miss a dose of warfarin, never take a double dose to catch up unless specifically advised by a doctor.

If you forgot to take your dose of antiplatelet drug, take the dose as soon as you remember, then continue to take your course as normal. Never double dose to make up for a missed dose. Take antiplatelet drugs with or after food to help reduce irritation to the stomach. When you are taking warfarin, Avoid binge drinking or getting drunk as doing this can increase the effect of warfarin and so increase the risk of bleeding. Maximum daily limit is three units of alcohol a day for man and two units a day for woman.

One unit is roughly equivalent to half a pint of beer or a single measure 25ml of a spirit such as vodka. Avoid situations that increase your risk of injury e. Seek immediate medical attention if you are bleeding a lot or it takes a long time for bleeding to stop. Get medical help if you have a hard blow to the head as you may have bleeding inside without knowing it. Communication with your doctor When you start taking warfarin as prescribed, tell your doctor about any medications or supplements that you are taking.

Storage of anticoagulants and antiplatelet drugs Anticoagulants and antiplatelet drugs should be kept in a cool and dry place. Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured. Treatment with blood thinners. Classification of blood thinners.

P2Y12 receptor antagonists a. Thienopyridine: Act by inhibiting the ADP-dependent pathway of platelet activation. Adenosine triphosphate analogue: Reversibly interact with the P2Y12 receptor to inhibit the receptor to prevent ADP-induced platelet aggregation.

Common side effects and precautions Drug class. Common side effects. Vitamin K antagonist. Use with caution in mild to moderate renal impairment. Monitor INR more frequently in severe impairment Not recommended for patients with severe hepatic impairment, or in first trimester of pregnancy Regular blood test to check how long it takes for your blood to clot INR test and dose may need to be adjusted.

Direct thrombin inhibitors.