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Blood Clots (cont.)


The treatment of blood clots often is directed at interfering with the normal clotting mechanism of the body. Different medications may be used to block specific factors in the clotting cascade and are chosen based upon the disease or illness being treated and other underlying medical issues that are present in the individual patient.

Aspirin is commonly used to decrease platelet function in the treatment of heart attack and stroke. Other anti-platelet drugs include clopidogrel (Plavix), ticlodipine (Ticlid) andaspirin and dipyridamole (Aggrenox).

There are several new drugs that act as blood thinners. These block either factor II or factor X. They can be taken by mouth either once or twice per day. They do not have the same need for blood tests as Coumadin. These medications include dabigatran, rivoroxaban, and apixiban.

Warfarin (Coumadin) acts as a blood thinner by blocking clotting factors (II, VII, IX and X) that depend upon vitamin K. Every patient is unique when it comes to the dosing requirements for warfarin (Coumadin), and blood tests are routinely done to make certain that the blood is anti-coagulated to the appropriate level. There are numerous drug interactions with this medication that can cause the blood to become "too thin" such as some antibiotics. Warfarin (Coumadin) dosing always needs to be monitored by a health care practitioner, and a patient should never alter the dose of this medication without consulting with their health care practitioner.

Heparin works by inactivating thrombin and factor X. It is an injectable medication available for use intravenously or as a low molecular weight medication called enoxaparin (Lovenox), which can be injected subcutaneously, under the skin. Heparin is often the first line drug in treating deep venous thrombosis and pulmonary embolus and is used routinely as part of the heart attack treatment protocol.

Tissue plasminogen activator (TPA or TNK) may be used to dissolve blood clots that are life-threatening and are most often used for clots that occlude arteries in situations such as stroke or heart attack, there are occasional instances in which the drug is used for major vein obstruction. The medication can be injected into an intravenous line that has been started in a vein of the arm, or it may be dripped directly into the clot. This requires specialized critical care technology and physician skill to thread a catheter to the site of blockage to deliver the clot-busting medication. Decisions regarding the use of this drug are individualized for the specific patient and situation.

Medically Reviewed by a Doctor on 5/27/2014
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