Drugs to Treat Blood Clots

There are several drugs used to prevent and break up clots. Drugs may be used alone or in combination. Three types of blood thinners treat clots. Anticoagulants, thrombolytics, and antiplatelets are commonly used agents.

Significance

• Blood clots cause thousands of strokes, heart attacks and pulmonary emboluses (clots in the lungs) each year. National Heart Lung and Blood Institute (NHLBI) estimates that there are 100,000 new cases of pulmonary emboluses each year. Of these, about 30 percent die.

Antiplatelets

• Antiplatelets work by preventing clot formation and preventing platelets from clumping together. Aspirin, one of the oldest medicines used today, is a prime early treatment for heart attack symptoms.

  Dr. Samuel Z. Goldhaber stated in a study published in the medical journal Circulation that chewing a 325 mg aspirin at the onset of heart attack symptoms increases survival by 20 percent. A low-dose aspirin of 81 mg is often recommended as a preventative in high-risk patients.

  Although there are several antiplatelets on the market, Plavix and Pletal are among the most widely used prescription drugs. Used in conjunction with aspirin, they decrease the risk of death even further.

Anticoagulants

• Anticoagulants decrease the blood's ability to clot, which helps prevent the growth of clots. Heparin, an IV medication has been long used to prevent clots. Heparin is used in the hospital setting and is closely titrated based on lab work that measures clotting time. Most hospital heparin protocols call for PTT levels to be drawn every six hours from patients on heparin. A scale details how much the dose should be adjusted in order to reach target range.

  Low molecular weight heparin is an alternative to heparin drips. Based on weight, it is injected in the abdomen with a very small needle. Lovenox is a commonly used LMWH, and patients may be sent home on a regimen of self-injections.

Thrombolytics

• Fairly new on the scene, thrombolytics are clot busters given to break up existing clots. Timing is very important. They may be given no more than four hours after symptoms of a stroke or heart attack appear. Quick transport to an emergency room where treatment can begin is paramount. These clot busters cannot tell a good clot that has sealed over a weak brain artery from a bad clot causing a heart attack. Streptokinase and tissue plasminogen activator (tPA) are in this category.

Risks and Benefits

• All medical treatments carry risks as well and benefits. Treatment with these medications may cause easy bruising or excessive bleeding. These drugs should only be used under close supervision by your physician. Be sure you know any adverse effects that may be experienced, and notify your healthcare provider promptly of any problems.