antikoagulasjonsprofylakse

Anticoagulation refers to the medical use of drugs that reduce or prevent blood clot formation. These medications do not dissolve existing clots; instead they slow the coagulation process to prevent new clots from forming or to limit the growth of current clots. Anticoagulation is used to lower the risk of stroke, pulmonary embolism, and other thromboembolic complications in various conditions.

The main drug classes include vitamin K antagonists, direct oral anticoagulants (DOACs), and parenteral anticoagulants. Vitamin K antagonists, such as warfarin, reduce the production of several coagulation factors, requiring regular blood tests to monitor the international normalized ratio (INR) and dose adjustments. DOACs, including dabigatran, rivaroxaban, apixaban, and edoxaban, directly inhibit thrombin or factor Xa and often do not require routine INR monitoring. Parenteral anticoagulants, such as unfractionated heparin and low molecular weight heparins (enoxaparin, dalteparin), are commonly used in hospital settings or for short-term therapy.

Indications vary and include prevention of stroke in atrial fibrillation, prevention and treatment of venous thromboembolism (deep vein thrombosis and pulmonary embolism), and management of certain mechanical heart valves or acute coronary syndromes. Dosing and choice of agent depend on factors such as renal function, weight, age, and concurrent medications; drug interactions and patient comorbidities influence management.

Bleeding is the principal risk of anticoagulation, requiring careful assessment of benefits and risks. Reversal strategies exist for major bleeding or urgent procedures, including vitamin K for warfarin, protamine for heparin, and specific reversal agents for DOACs in select settings. Monitoring and adjustment are essential to balance efficacy and safety.