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Blood Thinners

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Heather Robinson

on 20 January 2014

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Transcript of Blood Thinners

Blood Thinners
By Heather Robinson and Lydia Pearson
There are two types of blood thinners:

Anticoagulants are designed to lengthen the time it takes for blood to clot.
The most commonly used and prescribed anticoagulant is warfarin.
(MedlinePlus, 2014)
Anti-platelets prevent platelets in the blood from clumping together to form a clot.
The most commonly used or prescribed anti-platelet is ASA (acetylsalicylic acid).
Aspirin is a brand name for ASA.
(MedlinePlus, 2014)
Other Uses:

Anticoagulants such as warfarin have been used as rat poisons. Warfarin can be produced in solid or liquid baits. Rats that consume warfarin die from internal bleeding as the blood clotting is reduced and capillaries are damaged (PMEP, 1995).

Other uses:
Other than acting as an anti-platelet, ASA is also a pain killer, it reduces fever and is an anti-inflammatory (Drugs.com, 2014).
Risks/Side Effects: Warfarin

hair loss
bruising easily
low white blood cell count (harder to fight infections)
cramping, diarrhea
bleeding easily, dangerous bleeding
ex. haemorrhage (release of blood from a ruptured blood vessel) in tissues or organs
(Bristol-Myers Squibb, 2012).
increases the risk of small pieces of plaque breaking off within the arteries and traveling to various sites of the body causing inadequate blood flow and tissue damage (Bristol-Myers Squibb, 2012).
gangrene (occurs when body tissue dies)
(MedicineNet, 2014).
Risks/Side Effects: ASA
ulcers in stomach or duodenum
abdominal pain
gastritis (inflammation of stomach)
(MedicineNet, 2014)
reduced glomerular filtration rate
possible seizures
deep or rapid respiration
(Drugs.com, 2014)
Cost: ASA
0.028 cents per 325mg tablet
Cost: Warfarin
10 cents per 3 mg tablet

3 Types of Coverage
Ontario Drug Benefit (ODB) Program

This program covers the costs of most prescription drugs bought in Ontario for seniors, people on social assistance and those with disabilities or in special care (Ministry of Health and Long Term Care, 2014).
Third Party Payers
Extended benefit plans through third parties such as employers. Sometimes called a drug plan (Healthviews, 2011).
Private Payers
A private payer is someone who pays for the prescription drugs with their own personal money (Healthviews, 2011).
Blood clots when blood vessels are cut or damaged. Tiny blood particles called platelets become sticky and start to clump together (Kenny, 2012). Chemicals are released by blood cells and damaged tissues which react with clotting factors, and other chemicals or proteins in the blood. There are 13 known clotting factors. The last clotting factor causes small strands of proteins, fibrin, to form. This fibrin forms a mesh work, creating a clot (Kenny, 2012)

If there is abnormal blood clotting within the body or unwanted blood clots, blood thinners can be used to help prevent it.
How does blood clot?
How anticoagulants work:
Prothrombin is an important protein found in the blood. It is a key player when it comes to forming blood clots (NHS, 2013). Vitamin K helps produce prothrombin. When the blood clots, prothrombin turns into thrombin. Warfarin inhibits vitamin K, which then slows down the production of prothrombin lengthening the clotting time (NHS, 2013).
How anti-platelets work:
Anti-platelets prevent blood cells from clumping together to form a clot. Within the blood there is a chemical called thromboxane A-2. This chemical causes blood platelets to stick together. ASA inhibits the enzyme cyclo-oxygenase-1 (COX-1), the key player in the production of thromboxane A-2 (MedicineNet, 2014). This reduces the rate at which platelets stick and clump together, forming a blood clot.
What body systems to blood thinners effect?
Circulatory System
Anticoagulants target the clotting factors
Anti-platelets target platelets in the blood
Sometimes blood clots in the vessels when no damage has occurred
Blood thinners help to maintain homeostasis by allowing the blood to flow normally throughout the body without unwanted blood clots that may shift balance
(Blood Thinners, 2009)
Nervous System
The brain plays a large role in the nervous system
Unwanted blood clots can get lodged in the brain which may result in a stroke and can have a drastic effect on a person's vision, speech or cause seizures (National Stroke Association, 2012).
Respiratory System
Blot clots typically form in a deep vein and may travel through the circulatory system to the lungs (Kenny, 2012).
Unwanted blood clots can get lodged in the main blood vessel in the lungs causing shortness of breath, chest pain, coughing up pink frothy mucus and even death (Lung Disease & Respirator Health Center, 2011).
Controversial Issues
In 1951, a US soldier attempted suicide by consuming warfarin and was unsuccessful after several doses. The US soldier was treated with vitamin K, and recovered. After this incident, pharmaceutical industry wanted to use warfarin as a blood thinner despite the side effects. In 1954, warfarin was approved for human use as a blood thinner. The question that arises is if it is safe for humans to consume warfarin when it is also used as a rat poison. There are also many side effects (as listed earlier) associated with warfarin which raise some concern (Tatjana, M., 2011).

Who could benefit from the use of anticoagulants?
Who could benefit from the use of anti-platelets?
People suffering from the following conditions may be prescribed ASA:
individuals who have suffered from heart attacks or strokes
unstable angina
high blood cholesterol
high blood pressure
diabetes mellitus
family history of coronary heart disease
When prescribed, ASA is usually taken daily.
(MedicineNet, 2014)
individuals with artificial heart valves
individuals with blood clots in their body that may break loose and travel to the lungs
people with clotting disorders
individuals who have recently undergone knee or hip surgery
individuals who have suffered from heart attacks or strokes
Warfarin is often taken daily but prescriptions may vary.
(Bristol-Myers Squibb, 2012)
Our Recommendations
Blood thinners should not be used by:
Some pregnant women
Nursing mothers
Hemophiliacs (people who have a genetic disorder that causes a deficiency in one of the clotting factors)
(Bristol-Myers Squibb, 2012)
People with allergies to any of the drug ingredients
People with the flu or chicken pox
Individuals with severe kidney or liver diseases
People that currently have ulcers, especially if the ulcer is bleeding
(MedicineNet, 2014)
Inside a blood vessel
Natural Cures. (2012). Natural Cures for Blood Clots.
Find Home Remedy
. Retrieved from http://www.findhomeremedy.com/natural-cure-for-blood-clots/
Williams, G. (2013). The Illusion of a Single Perfect Dose.
Research. Retrieved from http://themixuab.blogspot.ca/2013/06/the-illusion-of-single-perfect-dose.html
Wong, Dr. M. (2007). Women &Stroke.
Lakeshore Vein & Aesthetic Clinic.
Retrieved from http://www.veinskin.com/women-stroke
MedicaLook. (2014). Pulmonary Embolism.
Medicalook Your Medical World
. Retrieved from http://www.medicalook.com/Lung_diseases/Pulmonary_embolism.html
CEPMED. (2013). What is Warfarin?
Warfarin Response
. Retrieved from https://cepmed.dnadirect.com/grc/patient-site/warfarin-response/index.html
After researching various types of blood thinners, it is concluded that they are beneficial when used as intended for the appropriate medical conditions. People requiring blood thinners have an imbalance in their body and struggle to maintain homeostasis. Blood thinners are used to treat the source of disruption in the physiological balance and help return the body to the desired equilibrium.
A health enhancing drug
(Ministry of Health and Long Term Care, 2014)
(Ministry of Health and Long Term Care, 2014)
Agriculture and Rural Development. (2002). Mice and Their Control. Alberta Government. Retrieved from http://www1.agric.gov.ab.ca/$department/deptdocs.nsf/all/agdex594
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Heart and Stroke Foundation. (2013). Anti-platelets (acetylsalicylic acid (ASA), clopidogrel, dipyridamole). Heart and Stroke Foundation. Retrieved from http://www.heartand stroke.com/site/c.ikIQLcMWJtE/b.3484139/k.C87F/Heart_disease__Antiplatelets.htm
Human physiology. (2011). Hematology. Human physiology. Retrieved from http://human physiology2011.wikispaces.com/05.+Hematology
Kenny, Dr. T. (2012). Pulmonary Embolism. Patient. Retrieved from http://www.patient. co.uk/health/pulmonary-embolism-leaflet
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National Stroke Association. (2012). Effects of Stroke. National Stroke Association. Retrieved from http://www.stroke.org/site/PageServer?pagename=effect
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PMEP. (1995). Warfarin. PMEP. Retrieved from http://pmep.cce.cornell.edu/profiles/extoxnet/ pyrethrins-ziram/warfarin-ext.html#top
Tatjana, M. (2011). Dangerous Side Effects of Blood Thinners as Warfarin (Coumadin). Hub Pages. Retrieved from http://tatjana-mihaela.hubpages.com/hub/warfarin-coumadine-side-effects
Williams, G. (2013). The Illusion of a Single Perfect Dose. LKB Research. Retrieved from http://themixuab.blogspot.ca/2013/06/the-illusion-of-single-perfect-dose.html
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