Isn't My Blood Thin Enough Already?


"Isn't that the same stuff they put in rat poison?  I don't want to take that, I think my doctor is trying to poison me!" said the customer as he was approaching the counseling area in the pharmacy where I work.

"Well sir, yes, the ingredients in this medication are similar to a rat poison prduct, however, I do not believe your doctor is trying to poison you.  The dose and the intention of treatment are a little different", I said.

We went on to have the conversation about why his doctor was starting him on a blood thinning medication.  We first started with the concept that the medication does not actually thin the blood; rather, it helps slow the time it takes for the blood to clot.   I helped the gentleman understand that his doctor was prescribing him this medication to help him from developing a blood clot that may get stuck in his legs, lungs, heart or brain. 

Specific conditions pose an increased risk for developing a blood clot, such as irregular heart rhythm, a recent heart attack, heart valve replacement, and certain surgeries such as hip or knee replacement.   Blood clots form when there has been damage to the blood vessel, either the artery or the vein, and also when blood stops moving and becomes stagnant.

An artery blood clot may occur when someone has developed plaque along the inside of the blood vessel from increased cholesterol, called atherosclerosis. (read my blog topic discussing cholesterol) The plaque increase and limits the space the blood has to flow.  If the plaque ruptures then a blood clot may form and lead to a stroke or a heart attack.

A blood clot in the vein may occur when a person is immobilized for some reason and their muscles are not contracting to push the blood back to their heart.  Small clots begin to form in the stagnant blood along the walls of the vein.  These clots increase and eventually limit the amount of blood that returns to the heart. 

A blood clot may form in the heart when the heart is not beating in an organized fashion.  When the heart has irregular rhythm, blood tends to pool or stagnate in certain sections.  When the blood stagnates, little clots may form on inside wall of the heart.  These clots may then be pumped out into the circulatory system and lead to a stroke or a heart attack.

Until recently, Warfarin was the mainstay of anticoagulation therapy for most patients that needed this type of treatment.  Over the past year two new medications have been released that are appropriate for use in certain situations, and more options are available on the horizon. 
  • Dabigatran (Pradaxa-tm)
  • Rivaroxaban (Xarelto-tm)
  • Warfarin (Coumadin-tm)
This is a category of medication where becoming educated about your treatment, the side effects, drug interactions and precautions may significantly improve your outcome of therapy.   If you, or someone close to you takes one of these anticoagulation medications, I encourage you to logonto the Medication Counseling section of AudibleRx and listen to the MedicationSpecific Counseling SessionsTM for the anticoagulation medications.

Thanks
Steve

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