Anticoagulants: Types, Mechanism, Uses, and Side Effects | MBBS Notes

High-yield pharmacology notes for NEET PG, FMGE & MBBS students.

Anticoagulants

Types

• Heparin
• Low molecular weight heparins (enoxaparin, dalteparin, tinzaparin, fondaparinux)
• Heparinoids (danaparoid)
• Direct thrombin inhibitors (lepirudin, dabigatran, rivaroxaban)
• Anticoagulant prostanoids (epoprostenol, alprostadil)
• Sodium citrate
• Warfarin

Mechanism of Action

• Heparin enhances antithrombin activity and reduces clot formation.
• Low molecular weight heparins mainly inhibit factor Xa.
• Heparinoids are useful in heparin-induced thrombocytopenia.
• Lepirudin directly inhibits thrombin.
• Dabigatran and rivaroxaban are oral anticoagulants used in thromboembolism.
• Prostanoids regulate thromboxane and prostacyclin balance.
• Sodium citrate binds ionized calcium.
• Warfarin inhibits vitamin K dependent clotting factors.

Uses

• Extracorporeal circulation
• Prevention and treatment of thromboembolic disorders

Routes of Administration

• Intravenous: heparins, prostanoids, sodium citrate
• Subcutaneous: heparins
• Oral: warfarin

Side Effects

• Bleeding
• Hypotension (prostanoids)
• Heparin-induced thrombocytopenia
• Hypocalcemia (sodium citrate)

Notes

• Alprostadil is less potent than epoprostenol.
• Sodium citrate is useful in extracorporeal circulation.

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