Anticoagulant therapy is a medical treatment used to prevent or treat blood clots, also known as thrombosis. The benefits of anticoagulant therapy include the prevention of deep vein thrombosis, pulmonary embolism, and stroke. The negative aspects of anticoagulant therapy include an increased risk of bleeding, cost associated with the therapy, and the side effects of the anticoagulant medications.
Medications are used in anticoagulant therapy to decrease the risk of blood clot formation. Many people call these medications blood thinners. A number of medications are used as anticoagulants, including heparin, warfarin, and enoxaparin. All of these medications have unique side effects, benefits, costs, and safety profiles.
The main pro of anticoagulant therapy is preventing the formation of blood clots. Often these blood clots grow in the deep veins of the legs, where they can cause localized redness or swelling. The real danger of these blood clots, though, comes when a piece of the clot breaks off and travels to the lungs. The medical term for this phenomenon is pulmonary embolism, and it can cause acute shortness of breath, increased rate of breathing, and low blood pressure. A large pulmonary embolism can be life threatening.
Another pro of anticoagulant therapy is that it can prevent the formation of thrombosis in the heart. An abnormal heart rhythm known as atrial fibrillation makes patients susceptible to forming blood clots in the atria of the heart; valvular abnormalities of the heart also predispose towards the formation of thrombi in the heart. When pieces of these clots break off, they travel to the brain and cause strokes. Blood thinning agents decrease the risk of forming these dangerous clots.
The largest con of anticoagulant therapy is that there is an increased risk of bleeding in patients receiving the therapy. Bleeding can occur from external wounds, inside the gastrointestinal tract, or within the brain. Risk of bleeding is higher if excessive anticoagulation therapy is given, or if patients are taking medications that interfere with the anticoagulant medications. Patients with uncontrolled hypertension, a history of easy bleeding, concurrent use of antiplatelet drugs, or who are older than 75 are typically not good candidates for anticoagulation therapy due to their elevated bleeding risk.
Another con of anticoagulant therapy is the cost associated with the therapy. Warfarin is considered to be the cheapest option for anticoagulation therapy, but it requires regular lab work to check the effect it is having on the blood. Heparin is typically only available for use in the hospital. Enoxaparin can be used as an outpatient medication, but it has a high cost and must be given as a shot.
Other cons of anticoagulation therapy involve the specific side effects associated with each anticoagulation medication. Warfarin can cause skin necrosis and birth defects. Heparin can cause low platelet counts in the blood. All medications are associated with the risk of allergy or anaphylaxis in susceptible patients.