Talk:Anticoagulant

Proposed merge
Anticoagulation in pregnancy is currently too short to be an article by itself, so it would be better to merge it into this article.—greenrd 13:03, 22 June 2007 (UTC)
 * Oppose. The article was created a couple hours ago.  Give me some time!  Anticoagulation in pregnancy has a number of special issues associated with it, such as the various regimens available, when to change regimen, risks associated with each regimen, etc.  Also indications for anticoagulation in pregnancy are not always the same as general anticoagulation (ie: If I recall correctly, some women only develop deep venous thrombosis during pregnancy).  The topic should be able to stand on it's own and be interesting for a number of people facing this issue.Ksheka 13:08, 22 June 2007 (UTC)
 * Another reason to oppose the merge is that this topic may garner interest from two entirely different groups of people. People who are interested in anticoagulation and people interested in pregnancy, and if it is merged into either anticoagulant or pregnancy, you will lose the other group.Ksheka 14:46, 22 June 2007 (UTC)

oppose!!!!! two different subjects should not be placed to gether although both are almost the same it is still different. i agree wit ksheka not to merge both articlesUser:tom


 * Oppose. These are both big topics whose pages are currently thin and need time to grow. If they are merged now, I think they will eventually have to be unmerged.Badgettrg 12:12, 4 July 2007 (UTC)

''The opposition has spoken. Anticoagulation in pregnancy is almost the same length as Anticoagulant and has many more references. No good reasons have been put forth to merge the articles, while a few good reasons have been mentioned to keep them apart. I am considering the issue closed.'' Ksheka 12:24, 23 July 2007 (UTC)

as Rat Poison
The article Coumatetralyl links here, but there is no mention here of how anticoagulants work as rat poison. I particularly wanted to find reference to the claim that they make rats thirsty, which dives them outside. --Hugh7 (talk) 07:05, 30 November 2017 (UTC)

Phase change is not "thinners"
I know in medical and common terminology anticoagulants are called blood thinners, but they don't really change the viscosity of the blood. anticoagulants try to inhibit a phase change occurring by means of stopping the whole coagulation cascade dropping out of solution to form a clot — Preceding unsigned comment added by JUBALCAIN (talk • contribs) 14:07, 11 April 2020 (UTC)

Leeches
Would be worth mentioning hirudo medicinalis's anticoagulant uses


 * We could devote a section to anticoagulants in nature. Hirudo is definitely worth mentioning, especially its use (hirudin, lepirudin). JFW | T@lk  19:59, 31 October 2007 (UTC)

Leeches
Would be worth mentioning hirudo medicinalis's anticoagulant uses


 * We could devote a section to anticoagulants in nature. Hirudo is definitely worth mentioning, especially its use (hirudin, lepirudin). JFW | T@lk  19:59, 31 October 2007 (UTC)

Review
Targeted inhibition of coagulation: JFW |  T@lk  19:59, 31 October 2007 (UTC)

Double blind
- the title suggests that double-blind trials are not always ideal, and uses anticoagulants as an example. I wonder what they're getting at... JFW | T@lk  17:44, 25 November 2007 (UTC)

Drotrecogin alfa
Is it possible Xigris has anti-coagulant effects because of the role played by Protein C? I am ignorant of how it is metabolized. Nagelfar (talk) 16:57, 3 January 2008 (UTC)

Plavix
If I take plavix, is it safe to take anticoagulant? Miss mossie christian —Preceding unsigned comment added by Miss mossie christian (talk • contribs) 13:12, 31 March 2010 (UTC)

drugs and diet with oral anticoagulant/warfarin —Preceding unsigned comment added by 117.200.61.14 (talk) 18:17, 12 December 2010 (UTC)

Measuring activity of the newer anticoagulants
10.1111/jth.12096 (review in JTH). JFW &#124; T@lk  21:00, 11 December 2012 (UTC)

Guidelines for bleeding in people on anticoagulants
... from the British Committee for Standards in Haematology 10.1111/bjh.12107 JFW &#124; T@lk  16:15, 13 December 2012 (UTC)

"Bridging"
... is a hot subject/potato in anticoagulation services. Here's a review 10.1111/bjh.12644 JFW &#124; T@lk  23:15, 21 November 2013 (UTC)


 * What is "bridging"? Greensburger (talk) 03:43, 22 November 2013 (UTC)


 * It is the use of short-acting anticoagulant drugs in periods just before and after surgery to prevent thrombosis while longer-acting drugs such as warfarin cannot be given. JFW &#124; T@lk  20:36, 20 February 2014 (UTC)

Reversal
NOACs are difficult to reverse - Blood 10.1182/blood-2013-09-529784 JFW &#124; T@lk  20:36, 20 February 2014 (UTC)

DOACs in the elderly
May lead to bleeding 10.1161/CIRCULATIONAHA.114.013267 JFW &#124; T@lk  19:14, 23 July 2015 (UTC)

NOACs vs warfarin
Major bleeding and mortality both reduced in the 13 trials included in meta-analysis. 10.1111/jth.13139 JFW &#124; T@lk  14:36, 17 September 2015 (UTC)

Measurement
... of DOACs reviewed here 10.1111/bjh.13810 JFW &#124; T@lk  09:37, 27 October 2015 (UTC)


 * ... as well as here: 10.1111/jth.13266 JFW &#124; T@lk  12:06, 27 January 2016 (UTC)

Nephropathy
A recently recognised problem: nephropathy due to overanticoagulation mostly described in warfarin use 10.1111/jth.13229 JFW &#124; T@lk  10:05, 20 December 2015 (UTC)

Periprocedural management
10.1111/jth.13305 JFW &#124; T@lk  23:38, 19 March 2016 (UTC)


 * ... and a UK guideline 10.1111/bjh.14344 JFW &#124; T@lk  22:44, 12 October 2016 (UTC)

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Student Workplan
Hello, I am a 4th year medical student enrolled in Wikiproject and am going into internal medicine. I am excited to contribute more information to the anticoagulant page on Wikipedia. Specifically, I would like to expand upon the new advances in anticoagulation therapy as well as mention some of the landmark trials. Furthermore, I would like to address the paradigm shift towards a more conservative management. I would like to discuss the following sections in further detail:

1) Medical Uses: - include postpercutaneous intervention, surgical prosthetic heart valves, heart failure

2) Adverse effects: - mention some of the nonhemorrhagic adverse effects of anticoagulation therapy (for example, heparin-induced thrombocytopenia and osteoporosis) - discuss bleeding complications of surgery and major falls with patients on anticoagulants

3) Types - although term "DOAC" is a well-accepted term, newest CHEST naming criteria for NOAC now represents "Non-vitamin K"

4) Coumarins (Vitamin K antagonist) - expand the section to include the fact that patients on Coumadin need to be monitored with INR (

5) Heparin and Derivative substances - talk about the fact that heparin is commonly used in acute thrombotic episodes

6) Other Types of anticoagulants - mention betrixaban

7) Add more resources for each statements.  — Preceding unsigned comment added by SteveKong3 (talk • contribs) 16:29, 9 January 2020 (UTC)

I also think that the cost of some of these medications (NOAC) can be a major concern and hinderance to some patients. Lastly, I would like to include a diagram of the coagulation cascade and at which step the major classes of anticoagulants act. — Preceding unsigned comment added by SteveKong3 (talk • contribs) 08:43, 9 January 2020 (UTC)

Peer Review
Overall, I think you did a great job updating this article with the most current evidence-based approach towards prescribing anticoagulants. One thing that I did notice after reading your workplan is that you were originally planning on adding a discussion of recent efforts to use a more conservative approach than in the past. However, the only time that I see this recent paradigm shift mentioned is briefly in the reversal agents section. I believe that it is a discussion worthy of being included in the lead section. Really great graphic that you created for this article as well. All of the work that you did was an improvement on what was already there, so most of my corrections are nit-picky things like grammar/spelling, but I have added a few comments on the sections that you edited heavily:

Lead paragraph has a lot of history in it. Could maybe add a history section near the bottom and keep relevant information about current medical uses or the recent paradigm shift in prescribing anticoagulants in the lead paragraph. Regular users often only read the lead paragraph when looking for the most pertinent and useful information, so information about where warfarin originated from may not be appropriate for this section.

Medical Uses: This section was already pretty well done but you expanded on it with useful and pertinent information. The wording (most of which didn't come from your edits) could use some polishing, For instance:


 * The sentence "The biggest risk of anticoagulation therapy is the increased risk of bleeding" would be more appropriate in the adverse effects section.


 * "prevention of or reduction of progression of a thromboembolic disease" could be changed to "preventing or reducing thromboembolic disease" to make it flow a little better.


 * In "Some indications for anticoagulant therapy that are known to have benefit from therapy include", the word "have" in this sentence is redundant and could be removed.

Adverse Effects: This section is similar to the previous section. Very well done with great sources used, but the wording could be polished up a bit. Some examples are:


 * In the first sentence, it should be either "the most serious and common adverse effect … is" or "the most serious and common adverse effects … are"


 * It is important to remember the intended audience that will be reading the article and minimize the use of medical jargon. For example, instead of saying "patients with renal impairment" you could say "people with kidney disease". Also, in accordance with the WikiProject Medicine standards, the word "patient" should be avoided and should be replaced with "person/people" since these articles are not intended solely for other healthcare providers.


 * Lastly, a lot of the second half of this section discusses the mechanism of action of warfarin and heparin for the first time in the article and may be better suited for a separate section dedicated to mechanism of action for some of the more frequently used or famous anticoagulants. This would help keep the "Adverse Effects" section more focused and pertinent.

Types: In this section, you added a lot of really useful and pertinent information (especially reversal agents, this was a very needed section). Big improvements to this section that you added also include the benefits of using NOACs over DOACs. Great additions all around with great use of credible sources.

— Preceding unsigned comment added by Tmurph525 (talk • contribs) 11:29, 28 January 2020 (UTC)

Anti-coagulation and COVID-19
Reportedly many fatalities of COVID-19 might be preventable with anticoagulation. Afaics there is very good evidence that heparin improves survival substantially, some indication that aspirin may offer some protection, testing is reportedly underway for rivaroxaban. However .. there does not appear to be any data regarding Vit K antagonists? This is pretty serious.. a large share of the highest risk COVID-19 patients is probably premedicated with Vit K antagonsists or DOACs and it does not appear that it works truly well for them. Richiez (talk) 22:47, 28 October 2020 (UTC)

Bruising
Doesn't mention can cause bruising Pavessey (talk) 09:18, 7 June 2022 (UTC)

"The presence of bruises may be seen in patients with platelet or coagulation disorders, or those who are being treated with an anticoagulant." Pavessey (talk) 09:28, 7 June 2022 (UTC)

https://en.m.wikipedia.org/wiki/Bruise Pavessey (talk) 09:29, 7 June 2022 (UTC)