Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 1987 Nov;33:2557–2560.

The Principles and Practice of Anticoagulant Therapy

Cedric J Carter
PMCID: PMC2218685  PMID: 21263997

Abstract

The author describes the clinical rationale and pharmacology of current anticoagulant therapy. He goes on to discuss the intensity of therapy by means of oral anticoagulants, the means of monitoring this therapy, and the standardization of monitoring procedures. He also describes the indications for and best means of administering and monitoring heparin therapy, together with the major clinical indications for both heparin and oral anticoagulant therapy.

Keywords: anticoagulant therapy, heparin therapy, therapy monitoring

Full text

PDF
2557

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Coe N. P., Collins R. E., Klein L. A., Bettmann M. A., Skillman J. J., Shapiro R. M., Salzman E. W. Prevention of deep vein thrombosis in urological patients: a controlled, randomized trial of low-dose heparin and external pneumatic compression boots. Surgery. 1978 Feb;83(2):230–234. [PubMed] [Google Scholar]
  2. Dale J., Myhre E., Loew D. Bleeding during acetylsalicylic acid and anticoagulant therapy in patients with reduced platelet reactivity after aortic valve replacement. Am Heart J. 1980 Jun;99(6):746–752. doi: 10.1016/0002-8703(80)90625-0. [DOI] [PubMed] [Google Scholar]
  3. Damus P. S., Hicks M., Rosenberg R. D. Anticoagulant action of heparin. Nature. 1973 Dec 7;246(5432):355–357. doi: 10.1038/246355a0. [DOI] [PubMed] [Google Scholar]
  4. Gallus A., Jackaman J., Tillett J., Mills W., Wycherley A. Safety and efficacy of warfarin started early after submassive venous thrombosis or pulmonary embolism. Lancet. 1986 Dec 6;2(8519):1293–1296. doi: 10.1016/s0140-6736(86)91431-5. [DOI] [PubMed] [Google Scholar]
  5. Glazier R. L., Crowell E. B. Randomized prospective trial of continuous vs intermittent heparin therapy. JAMA. 1976 Sep 20;236(12):1365–1367. [PubMed] [Google Scholar]
  6. Harris W. H., Salzman E. W., Athanasoulis C., Waltman A. C., Baum S., DeSanctis R. W. Comparison of warfarin, low-molecular-weight dextran, aspirin, and subcutaneous heparin in prevention of venous thromboembolism following total hip replacement. J Bone Joint Surg Am. 1974 Dec;56(8):1552–1562. [PubMed] [Google Scholar]
  7. Hirsh J., van Aken W. G., Gallus A. S., Dollery C. T., Cade J. F., Yung W. L. Heparin kinetics in venous thrombosis and pulmonary embolism. Circulation. 1976 Apr;53(4):691–695. doi: 10.1161/01.cir.53.4.691. [DOI] [PubMed] [Google Scholar]
  8. Hull R., Hirsh J., Jay R., Carter C., England C., Gent M., Turpie A. G., McLoughlin D., Dodd P., Thomas M. Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med. 1982 Dec 30;307(27):1676–1681. doi: 10.1056/NEJM198212303072704. [DOI] [PubMed] [Google Scholar]
  9. Intensity of oral anticoagulation in patients monitored with various thromboplastins. N Engl J Med. 1983 May 19;308(20):1228–1229. doi: 10.1056/NEJM198305193082015. [DOI] [PubMed] [Google Scholar]
  10. Levine M. N., Hirsh J. Hemorrhagic complications of anticoagulant therapy. Semin Thromb Hemost. 1986 Jan;12(1):39–57. doi: 10.1055/s-2007-1003533. [DOI] [PubMed] [Google Scholar]
  11. Lewis S. M. Thromboplastin and oral anticoagulant control. Br J Haematol. 1987 May;66(1):1–4. [PubMed] [Google Scholar]
  12. McKenna R., Galante J., Bachmann F., Wallace D. L., Kaushal P. S., Meredith P. Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression. Br Med J. 1980 Feb 23;280(6213):514–517. doi: 10.1136/bmj.280.6213.514. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Salzman E. W., Deykin D., Shapiro R. M., Rosenberg R. Management of heparin therapy: Controlled prospective trial. N Engl J Med. 1975 May 15;292(20):1046–1050. doi: 10.1056/NEJM197505152922002. [DOI] [PubMed] [Google Scholar]
  14. Turpie A. G., Levine M. N., Hirsh J., Carter C. J., Jay R. M., Powers P. J., Andrew M., Hull R. D., Gent M. A randomized controlled trial of a low-molecular-weight heparin (enoxaparin) to prevent deep-vein thrombosis in patients undergoing elective hip surgery. N Engl J Med. 1986 Oct 9;315(15):925–929. doi: 10.1056/NEJM198610093151503. [DOI] [PubMed] [Google Scholar]
  15. Turpie A. G., Levine M. N., Hirsh J., Carter C. J., Jay R. M., Powers P. J., Andrew M., Magnani H. N., Hull R. D., Gent M. Double-blind randomised trial of Org 10172 low-molecular-weight heparinoid in prevention of deep-vein thrombosis in thrombotic stroke. Lancet. 1987 Mar 7;1(8532):523–526. doi: 10.1016/s0140-6736(87)90173-5. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES