1. If patient is taking new oral anticoagulant called direct thrombin inhibitor

Question

1. If patient is taking new oral anticoagulant called direct thrombin inhibitor how is this drug affecting his coagulation process? How is this action different from warfarin?

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Explanation / Answer

1. If patient is taking new oral anticoagulant called direct thrombin inhibitor how is this drug affecting his coagulation process? How is this action different from warfarin?

warfarin is one of the drugs which form the class of blood thinners. Warfarin acts by inhibition of the synthesis of the clotting factors that are dependent in vitamin K as well as the active forms of these clotting factors are dependent on calcium. The clotting factors affected are factor II, VII factor X as well as factor IX. Warfarin carries our reduction of the enzyme epoxied reducfase, which is important in action of the coagulation factors. When epoxied reductase is inhibited, there would be inhibition of carboxylation activity of the enzyme glutamyl carboxylate, and thus they become biologically inactive.

The action of direct thrombin inhibitors is different from that of warfarin. These act by inhibition of thrombin that us fibrin bound, . Also, it carries out inhibition of fluid phase thrombin. These would not be binding to plasma proteins like warfarin or like other blood thinners. These would be binding directly to the thrombin and consequently blocks the thrombin to bind to other substrates. Example, bivalirudin, ximelagatran etc. Thrombin carries out conversion of fibrinogen to fibrin, and hence when thrombin is inhibited, the coagulation cascade is stopped.

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