Generality
Warfarin - the active ingredient of the registered specialty Coumadin ® - is an oral anticoagulant drug taken to "thin the blood" and prevent clots from forming in the circulation.
In Italy, coumadin can be purchased in common pharmacies upon presentation of a regular medical prescription; It is available as 5 mg circular tablets, divisible into 2 or 4 parts.
Insights
Warfarin indications
Warfarin: Chemical Structure
Coumadin is used in a "wide range of pathologies to prevent thromboembolic episodes. We recall, briefly, that a thrombus is a clot (" a clot "of blood) formed within the blood circulation, while an embolism appears, for example. , when a fragment of thrombus obstructs a blood vessel (the embolus, in this case, is the piece of lump that circulates in the bloodstream). The chances of this happening are greater when there is a slowdown in circulation, for example due to prolonged immobility in bed.
Since clots are called thrombus, their formation is called thrombosis. The most dangerous consequences of thrombosis are acute myocardial infarction, stroke, ischemia of a limb up to gangrene and mesenteric infarction.
Main indications of coumadin
- ATRIAL FIBRILLATION: the heart does not beat in a coordinated way and clots (thrombi) can form inside it
- DEEP VENOUS THROMBOSIS: in this disease the risk of clots (thrombi) forming inside a vein is very high; the clot can then rupture, be pushed to the heart by the blood and from there to the lungs where it causes pulmonary embolism
- HEART VALVE PROSTHESIS: in patients who have had heart valves replaced, clots may form on the surface of these new valves, with an increased risk of heart attack and stroke
One of the main therapeutic indications of coumadin is deep vein thrombosis, which leads to the formation of thrombus in the veins of the lower limbs, especially after a long immobility. In most cases, thrombi dissolve spontaneously, but it can happen that they break and that the generated fragments (emboli) are pushed by the blood along the bloodstream. These fragments are carried by the bloodstream, in increasingly large vessels, to the heart, which in turn pushes them into the arteries of the lungs. Here, the blood vessels narrow again and the clots stop causing a life-threatening obstruction - called pulmonary embolism - which can manifest with symptoms such as shortness of breath, cough, cyanosis and chest pain.
Coumadin is also used by patients with atrial fibrillation and by those with artificial heart valves, as a prophylaxis of heart attack. In addition, the drug is used in the prevention of reinfarction and thrombosis in patients undergoing particular surgery and in those affected from antiphospholipid syndrome.
The plasma half-life of warfarin is around 36 hours. The drug is metabolized by the liver and excreted in the urine. Some coagulation factors produced by the liver (II, VII, IX and X) require the presence of vitamin K to be active. Coumadin acts by preventing the ex-novo synthesis of these factors, while it is not active towards those already formed; for this reason the peak of the effects is not observed for two or three days.
Diet and coumadin "
