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Anticoagulants and Treatment of Venous Thromboembolism

  • Allison Burnett
  • Jack Ansell
Chapter

Abstract

Anticoagulants are the mainstay for the treatment of venous thromboembolism (VTE). Once VTE is established, anticoagulants limit the progression of VTE, reduce the chance of pulmonary embolism, and reduce the risk of recurrent VTE, while natural fibrinolytic processes lyse and reduce the existing thrombus or eliminate it altogether. The parenteral anticoagulants are traditionally used for hospitalized patients to achieve immediate anticoagulation, and the oral vitamin K antagonist (VKA) anticoagulants are used for long-term outpatient therapy. The VKAs require precise management to maintain a therapeutic level of anticoagulation and balance the benefit of the drug versus the risk of bleeding. A new class of oral anticoagulants, the direct oral anticoagulants (DOCAs), was recently introduced, and they are quickly becoming the preferred treatment for VTE. Because of their mechanism of action and pharmacokinetics, they often require no initial parenteral anticoagulation and, for long-term treatment, less direct management compared with the VKAs. This chapter focuses on the mechanism of action, pharmacokinetics, pharmacodynamics, and management of these classes of parenteral and oral anticoagulants.

Keywords

Heparin Low-molecular-weight heparin Warfarin Vitamin K antagonists Direct oral anticoagulants Venous thromboembolism Deep venous thrombosis Pulmonary embolism 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Allison Burnett
    • 1
  • Jack Ansell
    • 2
  1. 1.University of New Mexico Hospital Inpatient Pharmacy DepartmentAlbuquerqueUSA
  2. 2.Hofstra Northwell School of MedicineHempsteadUSA

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