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What Is Antithrombotic Therapy?

The goal of antithrombotic therapy is to stop blood clots before they cause major harm. Emergency thrombolytics, aspirin, and heparin are examples of anticoagulants and antiplatelets, respectively.

When a blood clot forms in an artery or vein, it is known as thrombosis. Problems may arise if the clot stops blood flow to your cells and organs. Big clots and clots that form in the incorrect location can pose a threat.

Antithrombotic treatment is one tool that doctors might use to prevent clots from developing. Additionally, they can utilise it to dissolve an existing clot.

What you should know about antithrombotic therapy, including the kinds of drugs that physicians can recommend, is provided here.


Why worry about blood clots?

You may be familiar with deep vein thrombosis (DVT), a disorder associated with blood clots. DVT refers to a clot that is located in a deep vein, most commonly in the lower leg, thigh, or pelvis, but occasionally in the arm. These clots have the potential to break off and cause pulmonary embolism, a potentially fatal condition that travels to your lungs.

The medical term for a blood clot that develops in an artery is arterial thrombosis. Such a blood clot may result in a stroke or heart attack.


What’s the purpose of antithrombotic therapy?

Medication is used in antithrombotic therapy to lessen the possibility of blood clots in your arteries or veins. If your doctor believes you could be at risk for a heart attack, stroke, or other health issue as a result of a clot, they may prescribe these drugs.

To treat thrombosis, doctors can recommend one of three main categories of drugs. They might advise using one or a mix of them. These drugs are capable of:
  • delay clotting
  • prevent the coagulation of your blood's platelets
  • dissolve an existing, potentially hazardous clot


What are the types of antithrombotic therapy?

Three different medication classes either prevent or lessen the risk of thrombosis. These are the following:
  • anticoagulants
  • thrombolytics
  • antiplatelet agents
Each type works differently.

Anticoagulants

White blood cells, platelets, red blood cells, and fibrin are the same components found in all blood clots. Your body employs a blood protein called fibrin to repair damaged tissue and promote wound healing.

These constituents are prevented from adhering to one another to form a clot by anticoagulants and antiplatelets. Both function differently, despite sharing the name "blood thinners."

Anticoagulants reduce the speed at which your body forms clots. They inhibit the growth of pre-existing clots and make it more difficult for your body to generate new ones. They do not dislodge already-formed clots.

Antiplatelets

Antiplatelets function differently from anticoagulants in that they also inhibit the formation of clots. They deal with the platelets directly.

Platelets are unique blood cells that clump together at the site of injury to form a clot and stop further bleeding. They don't fuse because of antiplatelets.

Thrombolytics (fibrinolytics)

Thrombolytic drugs disintegrate clots that have already formed, in contrast to anticoagulants and antiplatelets, which function to stop clots from forming in the first place.

They function by stimulating a liver protein that produces an enzyme that breaks down fibrin in clots fast.

When a clot is harmful and has resulted in serious health issues such as stroke, heart attack, or DVT, doctors utilise thrombolytics. Unlike the other kinds of drugs, they are not meant for regular usage. Rather, physicians save them for dire situations.


What are examples of antithrombotic therapy?

Anticoagulants include, for example:
  • heparin
  • warfarin
  • rivaroxaban (Xarelto)
  • edoxaban (Savaysa)
  • dabigatran (Pradaxa)
  • apixaban (Eliquis)
Antiplatelet drugs include, for instance:
  • aspirin
  • dipyridamole (Persantine)
  • ticlopidine (Ticid)
  • cangrelor (Kenreal)
  • vorapaxar (Zontivity)
  • clopidogrel (Plavix)
  • prasugrel (Effient)
  • ticagrelor (Brilinta)
  • abciximab (ReoPro)
  • eptifibatide (Integrilin)
To prevent or cure blood clots, your doctor may prescribe one drug, one drug plus aspirin, or a combination of drugs.

A person who has experienced a heart attack or stroke, for instance, might decide to use dual antiplatelet therapy. That entails taking aspirin and a prescription antiplatelet drug together. Physicians may advise them to take aspirin for the remainder of their lives and the recommended antiplatelet medication for several months or years.

In an emergency, doctors may administer intravenous thrombolytics such as:
  • alteplase (Activase)
  • reteplase (Retavase)
  • streptokinase (Streptase)
  • urokinase (Kinlytic)
  • tenecteplase (TNKase)
  • anistreplase (Eminase)

What are the side effects of antithrombotic therapy?

Antithrombotic treatment medicines can have negative effects, just like any other medication.

Though they differ depending on the drug, the adverse effects usually consist of:
  • a higher chance of bleeding
  • a stomach ache
  • nausea
  • diarrhoea

Is antithrombotic therapy safe for older adults?

Antithrombotic therapy may be beneficial for older adults, however they may be more prone to bleeding than younger adults. While developing a treatment plan, physicians must also take into account any additional comorbid conditions that they may have.

Aspirin taken daily may benefit certain individuals at risk of thrombosis but harm others as well.

The European Society of Cardiology Working Group on Thrombosis discovered in 2022 that taking aspirin every day for individuals over 70 years of age may occasionally be more harmful than beneficial.

Before beginning any new medicine, it's crucial to go over your whole medical history and current problems with your healthcare provider. Make sure you are aware of the advantages and disadvantages of each medication.


FAQs

Is aspirin antithrombotic therapy?

Over the past ten years, clinical investigations have shown that aspirin is a useful antithrombotic medication.

Are antithrombotic blood thinners?

Anticoagulants and antiplatelet medicines are the two groups of medications that prevent thrombosis. Anticoagulants inhibit the synthesis of fibrin and stop clots from forming and spreading by slowing down the clotting process. Antiplatelet medications stop platelets from gathering together and stop clots from forming and spreading.

Is antithrombin natural?

Natural anticoagulant proteins include protein C, protein S, and antithrombin III. Factor Va and factor VIIIa are cofactors that are inhibited by activated protein C and protein S.



Takeaway

Medication is used in antithrombotic therapy to stop your body from forming blood clots. These drugs may be able to disintegrate a potentially fatal blood clot that has already resulted in a serious issue, such as a heart attack or stroke.

Anticoagulants, antiplatelets, and thrombolytics are the three types of medications used in antithrombotic therapy. Your doctor may prescribe one or more of these, depending on your circumstances.

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