NP Corner

Why Do I Need a Blood Thinner?

By Lacretia Daniels, MSN, APRN, ANP-C

Blood thinners, also known as anticoagulation and antiplatelet medications, are used to decrease the blood's ability to clot. The blood is not actually thinned. The medications work to hinder the parts of the blood that cause clotting under normal circumstances. They are not used to break apart clots, but to keep new clots from forming or existing clots from getting larger. Some conditions which are treated with these medications include deep vein thrombosis, pumonary embolus, strokes caused by blood clots, some heart valve replacement, cardiomyoptahy and atrial fibrillation. Antiplatelet medications in particular are used to keep blood vessels open after angioplasty and stenting procedures.

Dep Vein Thrombosis can occur in any vein. Symptoms typically include swelling, paion or tenderness, increased warmth or redness. An ultrasound is usually used to diagnose this problem. While the body will usually dissolve the clot over time, blood thinners are used to stop the clot from getting bigger and to keep the clot from breaking off and moving to other parts of the body.

Strokes caused by clots frequently occur with atrial fibrillation, though not always. In atrial fibrillation, the upper chambers of the heart (atria) quiver instead of pumping strongly allowing the blood to pool and swirl. this allows for the blood to clot. In the event that the chambers pump normally or the clot moves to the bottom chambers (ventricles), it could travel to the brain occluding the vessels causing a stroke due to the lack of oxygen carrying blood to that tissue. In cardiomyopathy, the situation is similar, except blood would pool in the weakened ventricle. For this reason, anticoagulating medications are used.

A pulmonary embolism is a clot in the artery of the lungs. It is a clot that has, more than likely, traveled from another part of the body. Symptoms include chest pain, shortness of breath, fainting, irregular/rapid heartbeat and coughing up blood. It is typically diagnosed with CT scan of the chest or nuclear imaging. Pulmonary embolisms require emergency treatment, usually with blood thinners. Some patients may require a procedure to remove the clot.

Patients who are treated for coronary artery disease, peripheral vascular disease and sometimes strokes using angioplasty and/or stents are treated with antiplatelet therapy in order to keep the stents from developing blood clots. Blood flow is maintained and oxygen rich blood continues to reach the areas which need it.

In terms of anticoagulation medication, warfarin is among the oldest and most commonly used. It has a very narrow window of effectiveness, and frequent blood testing is required to monitor it. Foods which are high in Vitamin K can work against Warfarin. You should attempt to avoid these. There are newer drugs on the market: rivaroxaban, apixaban, edoxaban and dabigatran. These are taken by mouth and do not require monitoring. You may receive medicine by injection while hospitalized, and these include, heparin, fondaparinux and enoxparin; these medications are usually used prior to transitioning to oral medications.

It is best to take your medication as prescribed at the same time every day. You should prevent injury because you will be more likely to bleed. Be careful with sharp objects, where shoes outdoors, and avoid sports and other activities which could cause searious injury. If you fall, especially if you have a significant bump to your head, you should seek medical attention.

Works Cited

Answers by Heart: What are Anticoagulants and Antiplatelet Agents. (2012). Retrieved from American Heart Association

Blood Thinner Pills: Your Guide to Using Them Safely (2014, June). Retrieved from Agency for Healthcare Research and Quality

Deep Vein Thrombosis: Symptoms, Diagnosis, Treatment and Latest NIH Research. (2011). Retrieved from NIH MedlinePlus

Pulmonary Embolism. (2015). Retrieved from Healthline.