BLOOD THINNING OR ANTICOAGULANTS - COUMADIN

There are a number of blood thinning agents that are available in medicine. The drugs used over the years have included Coumadin, Heparin, Low molecular weight heparin or Lovenox, aspirin, Plavix, Ticlid, Persantine and Anturane.

What It Does 

Coumadin (warfarin) is a drug that is taken by mouth. It acts on various components of the blood clotting mechanism to prevent blood clotting in the body. A cascade of known blood factors act in sequence to cause the blood to form a blood clot. This activity is partly disrupted by the use of Coumadin.

What Test Is Required and Frequency to Control the Use of Coumadin

A blood test called the Prothrombin time is used to control the amount of Coumadin that an individual takes. It is standardized by an international unit called the INR, which has worldwide application. It is suggested by most cardiologists that a blood test for the Coumadin dosage be obtained at least every three weeks. Coumadin should be used at the end of the day so that one's blood test can be evaluated early in the day and the amount of Coumadin medicine prescribed changed if necessary by reviewing the blood test ie. the INR.

Health Conditions Requiring Coumadin

 There are a number of cardiac and other health conditions which prompt and advise the use of the anticoagulant, Coumadin. Those patients with most prosthetic (artificial) valves of the heart require Coumadin. The rhythm abnormality called atrial fibrillation, or an irregular heartbeat requires Coumadin. Big hearts or dilated hearts (cardiomyopathy) frequently require Coumadin. Pulmonary embolism or blood clots in the lung and thrombophlebitis or blood clots in the legs require anticoagulation with Coumadin. The distinct entity of pulmonary hypertension or high blood pressure in the lung artery frequently requires anticoagulation with Coumadin. Other specific blood clotting disease (coagulopathies) also may require the use of anticoagulation with Coumadin.

Over Medication With Coumadin

Over medication with Coumadin can cause severe bleeding and death. Bleeding may occur inside the head, inside the heart, inside the kidneys, the bowel or the lung. It commonly is seen as severe bruising in the skin. Adjustment of the Coumadin dosage would be essential.

Inadequate Anticoagulation of Blood Thinning

 These result is serious consequences as well with patients having cerebral vascular accidents (strokes), heart attacks or blood clots going to any organ or to any extremity.

When to Take Your Coumadin

 It is recommended that you take your Coumadin at the same time each day, usually before or after the evening meal. On the day of your Protime this allow your physician to reach you before you have taken your medication in case any adjustments are necessary.

SAFETY TIPS

Guard against cuts; wear shoes. When gardening or doing similar work wear gloves. The use of an electric shaver is advised.

Avoid food fads, crash diets or marked changes in eating habits. Certain foods are high in Vitamin K. These need not be avoided; however, a marked change in the amount of these will alter your response to Coumadin. These are alfalfa, cabbage, cauliflower, liver, spinach, soybeans, fish and fish oils.

Alcohol enhances the effect of Coumadin. If you drink, ask your physician about guidelines for amounts that are safe.

Don't play contact sports that can subject you to injury.

Have regular dental checks to assure oral hygiene and avoid disease. Remember to inform your dentist that you take Coumadin.

Women should notify their doctors as soon as they suspect they are pregnant.

Many factors can influence Coumadin response and Protime levels. These include diarrhea, decreased liver or kidney function, emotional upsets, harsh laxatives, vitamins, infections, weather changes, antibiotics, aspirin and other drugs.

You should wear or carry identification indicating that you are taking Coumadin. Cards are available and most pharmacies carry bracelets or necklaces with this information.

CALL YOUR DOCTOR IF:

• You have red or dark brown urine.
• You have red or black bowel movements. 
• You have a severe headache or severe stomach pains. 
• You have excessive bleeding after cuts. 
• You have excessive or unusual bleeding from any place on your body.
• You have dizziness, nausea or fever. 
• You have bruising (black and blue spots), pain or swelling from a minor bump. 
• You develop a rash. 
• WOMEN: If you have a very heavy or unusual menstrual period or if you become pregnant.

FACTORS THAT INCREASE YOUR PROTIME ( MAKE YOUR BLOOD TOO THIN)

MEDICATIONS

FACTORS THAT DECREASE PROTIME ( MAKE YOUR BLOOD TOO THICK)

MEDICATIONS

MEDICATIONS CONTAINING SALICYLATES

These medications contain aspirin (salicylates) and should not be used if you are using Coumadin. This is only a partial list, many medications contain aspirin and you should check the labels of all medications very carefully. Tylenol, Datril or other brands of Acetaminophen should be usedfor minor aches or pains. 

The importance of blood thinning or anticoagulation with Coumadin is very important for patient health. Adjustments of the Coumadin dosage should be made at least every three weeks by testing the blood Prothrombin time and the INR. Medications are prescribed by other physicians should be discussed with the physician or cardiologist who is caring for the Coumadin dosage. Failure to do so may result in catastrophic experiences.

The statements provided in this report are for information only.  This is not intended to be medical advice.  Each individual may react differently depending on a variety of circumstances.  It is therefore imperative you consult your physician prior to following any of the contents of this report.  CardioDoc.net and CardioDoc.org disclaim any and all liability.