Anti-coagulants
Name
ASPIRIN (acetylsalicylic acid) CLOPIDOGREL (Bisulfate) WARFARIN |
Effect
NSAID (reduces prostaglandin levels) and anti-coagulant/antithrombotic (inhibits platelet function). Anti-coagulant effect lasts longer than anti-inflammatory effect Pro-drug. Prevents ADP from activating platelets by binding to the P2Y12 receptor (P2Y12 inhibitor) Prevents the formation of blood clots by reducing the production of factors in the liver that promote clotting (factors II, VII, IX, and X) and the anticoagulant proteins C and S. These factors are dependant on sufficient vitamin K and Warfarin disrupts vitamin K |
Uses
Inflammation of; RA, SLE, juvenile RA, AS, Reiters Syndrome, OA, burstitis etc. As an anti-coagulant to reduce risk of stroke and MI. reduce the risk of stroke and MI and in patients with peripheral vascular disease or unstable angina. Often used in combination with aspirin (more effective in preventing another MI but risk of bleeding is higher) DVT and reduce the risk of PE, stroke and MI. Often used after major orthopeadic surgery to prevent the formation of L.ex DVT |
Dose
Dose for pain relief = 350-650mg every 4hrs, for prevention = 81mg, 162mg or 325mg per day. Initially 300mg/day then 75mg/day (often with 75-325mg aspirin/day) 2-10mg/day |
Side effect
Ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Can also cause tinnitus, vertigo, dizziness, rash and kidney impairment. May reduce the effects of Beta-Blockers, Methotrexate and should not be taken with other blood thinners. Diarrhea, rash, itching, abdominal pain, headache, chest pain, muscle aches and dizziness. Increased risk of stomach and intestinal bleeding when taken with NSAIDs . Effectiveness may be reduced by Omeprazole as it reduces activity of enzymes in liver needed to convert it into active form. Bleeding can occur in any tissue. The most serious side effects are bleeding and necrosis. Many pxx and OTC medications can interact with Warfarin and increase blood thinning. All patients taking it should consult their GP before taking any other medications |