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Stroke Medications

Stroke Medications: Antiplatelets & Anticoagulants

Anticoagulants are drugs used to prevent clot formation or to prevent a clot that has formed from enlarging. They inhibit clot formation by blocking the action of clotting factors or platelets.

Although blood clotting is essential to prevent serious bleeding in the case of skin cuts, clots inside the blood vessels block the flow of blood to major organs and cause heart attacks and strokes. Although these drugs are sometimes called blood thinners, they do not actually thin the blood. This type of medication will not dissolve clots that already have formed, although the drug stops an existing clot from worsening.

Most anticoagulant drugs are available only with a physician’s prescription. They come in tablet and injectable forms. They fall into three groups:

  • Inhibitors of clotting factor synthesis. These anticoagulants inhibit the production of certain clotting factors in the liver. One example is warfarin (brand name: Coumadin).
  • Inhibitors of thrombin. These drugs interfere with blood clotting by blocking the activity of thrombin. They include heparin and lepirudin (Refludan).
  • Antiplatelet drugs. These drugs interact with platelets, which is a type of blood cell, to block platelets from aggregating into harmful clots. They include aspirin, ticlopidine (Ticlid), clopidogrel (Plavix), tirofiban (Aggrastat), and eptifibatide (Integrilin).

Uses of Anticoagulants

Anticoagulant drugs are used for a number of conditions. For example, they may be given to prevent blood clots from forming after the replacement of a heart valve or to reduce the risk of a stroke or another heart attack after a first heart attack. They are also used to reduce the chance of blood clots forming during open-heart surgery or bypass surgery.

Low doses of these drugs may be given to prevent blood clots in patients who must stay in bed for a long time after certain types of surgery. They may also be used to prevent the formation of clots in needles or tubes that are
inserted into veins, such as indwelling catheters.

Anticoagulants may be given after major surgery to prevent the formation of clots due to lack of physical activity. Patients who are unable to move around may be at risk of developing clots, particularly in the legs. Anticoagulants are given to prevent this.

At the same time, compression stockings may be used to reduce the risk of clots in the legs. Compression stocks are worn on the lower legs, and act by increasing the pressure on the veins of the leg, then relaxing. The compression-relaxation keeps the blood in the veins moving, and reduces the risk of clots following surgery.

Risk Factors

Because anticoagulants affect the blood’s ability to clot, they can increase the risk of severe bleeding and heavy blood loss.

  • Essential to take these drugs exactly as directed
  • To see a physician regularly as long as they are prescribed.
  • Have regular blood tests, so your doctor can tell how the medicine is working.
  • Never take aspirin, unless you check with your doctor.
  • Tell other healthcare providers that you are taking anticoagulants
  • Always check with your doctor before taking other medications or food supplements, as they can alter the effectiveness of the anticoagulants.
  • Inform your physician if:
    • Your urine turns pink or red.
    • Your stools turn red, dark brown or black.
    • Your gums bleed.
    • You have a bad headache or stomach pain that does not go away.
    • You often find bruises or blood blisters.
    • You have an accident of any kind.