2023-12-26 07:00:42
In France, more than 220,000 new people are treated each year with an oral anticoagulant. These medications, which are essential in the prevention of certain major cardiovascular events, have a significant side effect, the risk of bleeding. Explanations.
Anticoagulants and oral anticoagulants
Les anticoagulants are medications whose objective is to prevent the formation of blood clots, which can block a vessel and therefore block blood circulation. They are prescribed to patients at risk to prevent serious or even fatal illnesses, such as:
These medications are also prescribed for some patients suffering from heart rhythm disturbancesas the fibrillation atriale or carriers of an artificial heart valve. There are several classes of anticoagulant drugs:
Les anticoagulants injectablesrepresented by heparins and heparin derivatives; Oral anticoagulants: the oldest are antivitamins K or AVK and since 2009 new oral anticoagulants have been put on the market, with three new molecules available.
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The bleeding risk of oral anticoagulants
Oral anticoagulants allow, through different mechanisms of action, thin the blood and therefore avoid the formation of a blood clot. By thinning the blood, these drugs increase the risk of bleeding and hemorrhage in patients for example in the event of injury, dental surgery or surgical intervention. Bleeding or hemorrhage can even occur spontaneously, without a trigger. They therefore require close medical monitoring to detect and prevent any bleeding problems.
To know ! Anticoagulants are not the only medications prescribed to thin the blood. There are also antiplatelet agents, which have a different mechanism of action. Anticoagulants act directly on blood clotting, while antiplatelet agents act only on blood platelets. Antiaggregants act at the arterial level, while anticoagulants act more at the venous level.
For patients on AVK, a specific blood dosage, the INR (International Normalized Ratio) allows the risk of bleeding to be assessed and the patient’s treatment to be adapted if necessary. Depending on the context, the doctor tells the patient how often the INR should be measured. For more recent oral anticoagulants, no dosage allows the risk of bleeding to be assessed and the patient must therefore monitor any suspicious signs, in particular by using the monitoring card given to them with their treatment. The presence of hematoma or blood in urine, stools, eyes, sputum, etc. should lead to urgent consultation with a doctor. Even in the event of a minor injury, the patient must consult a doctor to assess the bleeding risk and ensure the absence of hemorrhage, particularly intracranial.
To know ! In the case of VKAs, these medications interact with the intake of foods containing vitamin K. Patients on VKAs should limit the consumption of foods rich in vitamin K as much as possible, such as collard greens, spinach, broccoli , soy, carrot, blueberry or even salad.
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Watch for signs suggestive of hemorrhage
Beyond the risks of major bleeding, oral anticoagulants expose patients to other vascular disorders: bleeding from the gums or nose, hematomas. Other side effects can also be observed, most often minor this time:
Tiredness ; Nausea ; A change in the number of blood platelets; A drop in blood pressure which can cause discomfort; Itches ; Allergic reactions; A disturbance in the liver function test.
Anticoagulants are essential medications in the prevention of several major cardiovascular events. The main side effect to be aware of is the risk of bleeding.
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Estelle B., Doctor of Pharmacy
Sources
– Anticoagulant treatments.www.vidal.fr. Accessed December 11, 2023.
– How is anticoagulant treatment monitored? www.vidal.fr. Accessed December 11, 2023.
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