Alila Academy

Anticoagulants are medications that reduce blood clotting, or coagulation. They are used to treat and prevent unwanted blood clot formation in conditions such as atrial fibrillation, deep vein thrombosis, acute coronary syndrome, and in patients with a prosthetic heart valve. Anticoagulants are also used to prevent excess coagulation during surgery and dialysis.

Coagulation is critical for the control of bleeding, which has 4 stages:

• Stage 1: formation of platelet plugs. 
  
• Stage 2: formation of blood clots, which are essentially platelet plugs reinforced with strands of fibrin. 
  

Fibrin is the final product of the coagulation cascade - a multi-step chain reaction where one clotting factor activates the next. The 2 activation pathways, extrinsic and intrinsic, converge to produce thrombin and ultimately fibrin. Thrombin has a central role: it cleaves fibrinogen to generate fibrin, it further activates platelets, and initiates a positive feedback loop that is essential for clot propagation.

• Stage 3: termination of clot formation. Antithrombin is among a number of mechanisms designed to control the extent of clot formation. Antithrombin binds to thrombin, as well as several other clotting factors, and inhibits their function.

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