The Use Of Anticoagulant Therapy And Its Effects On The Treatment

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Epistaxis is defined as the occurrence of haemorrhage from the nose, which is relatively common and does not always need professional medical attention. However, prolonged or repeated events of nosebleeds, also known as 'recurrent idiopathic epistaxis ' may indicate certain bleeding disorders or potential adverse effects from the use of anticoagulant therapy. Warfarin (Coumadin) is a common anticoagulant that affects clotting factors that are produced in the liver. It is often administered after an myocardial infarction in order to prevent thrombosis and thromboemobolism which could lead to the development of a stroke, most of which are ischemic in origin. Despite its effectiveness, warfarin has been implicated in 50
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His laboratory tests showed an abnormal coagulation profile, which is perhaps attributed to his daily medication regime. Prothrombin time(PT) was significantly prolonged, whereas partial thromoboplastin time(PTT) was only mildly prolonged. The tests also revealed a lower than normal haematocrit, that being a direct result of prolonged bleeding. Also, his stool sample was tested positive for blood.
Homeostasis of Hemostasis
Blood coagulation is the process whereby a blood clot (thrombus) is formed. The formation of a thrombus represents the second stage of hemostasis, following vasoconstriction and platelet aggregation at the site of injury. The clotting process is very complex and its role is to maintain vascular integrity and to induce rapid clot formation after a vascular injury. It is vital to be able to regulate the production of thrombin, in order to prevent thrombosis, as well as maintaining normal blood circulation.
As shown by figure 1, the coagulation cascade is a protein based system which is initiated through the activation of two separate pathways designated extrinsic and intrinsic. These two pathways proceed through the common pathway of coagulation until fibrin is formed. The extrinsic pathway is generally the first pathway to be activated, and it is stimulated by tissue factor 'thromboplastin ' coming into direct contact with factor VII. Factor VII is
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