Prakt. lékáren. 2021; 17(1): 14-21 | DOI: 10.36290/lek.2021.002

Anticoagulation therapy - what a pharmacist should know

Jana Hirmerová

II. interní klinika Lékařské fakulty UK a Fakultní nemocnice Plzeň

Anticoagulant drugs affect the coagulation cascade in various ways. Parenteral anticoagulants include unfractionated heparin, low-molecular-weight heparins and fondaparinux, oral anticoagulants are represented by warfarin (vitamin K antagonist) and the novel group of direct oral anticoagulants (dabigatran - thrombin inhibitor; rivaroxaban, apixaban and edoxaban - factor Xa inhibitors). Principal indications of anticoagulants are prevention and treatment of venous thromboembolism and prevention of cardioembolic stroke in the patients with atrial fibrillation. Anticoagulants is a heterogeneous group and respective drugs differ in mechanisms of action, modes of application and pharmacokinetic properties (dependence on renal elimination and need for dose reduction or even contraindication in renal insufficiency, predictability of effect and need for laboratory monitoring, the potential to interact with drugs or food etc.). Anticoagulants as a class are associated with the risk of bleeding complications and therefore, it is necessary to use proper doses, to respect contraindications and to consider potential interactions. Optimal management of anticoagulation therapy require cooperation of physicians, pharmacists as well as thoroughly educated patients.

Keywords: anticoagulation therapy, heparins, warfarin, direct oral anticoagulants, venous thromboembolism, atrial fibrillation.

Published: April 15, 2021  Show citation