Anticoagulants (Blood Thinners): Uses, Types, and Examples

Anticoagulants inhibit clot formation by targeting coagulation factors. They do not “thin” blood but prevent fibrin formation.

Major Classes & Examples

• Heparins: Unfractionated heparin (IV, rapid, reversible), Low‑molecular‑weight heparin (enoxaparin, dalteparin – SC, predictable).
• Vitamin K Antagonist: Warfarin (oral, requires INR monitoring, diet interactions).
• Direct Oral Anticoagulants (DOACs): Dabigatran (thrombin inhibitor), rivaroxaban, apixaban, edoxaban (factor Xa inhibitors). Fixed dosing, no routine monitoring.
• Antiplatelet (often grouped): Aspirin (COX‑1 inhibitor), clopidogrel, ticagrelor – prevent platelet aggregation, used for arterial thrombosis.

Common Indications

• Atrial fibrillation (stroke prevention)
• Venous thromboembolism (DVT/PE treatment & prevention)
• Mechanical heart valves (warfarin required)
• Post‑orthopedic surgery prophylaxis
• Acute coronary syndrome (antiplatelets ± anticoagulant)

Key Safety Points

• Bleeding risk: assess HAS‑BLED, renal/hepatic function.
• Reversal agents: idarucizumab (dabigatran), andexanet alfa (factor Xa inhibitors), vitamin K/4F‑PCC (warfarin).
• Drug interactions (CYP3A4/P‑gp for DOACs).
• Patient education: signs of bleed, adherence, medical alert ID.