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J. O. Ballard, MD

JAMA. 1999;282:310-312.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Each year thromboembolism affects millions of individuals worldwide. As a result, anticoagulants are among the most commonly prescribed drugs in clinical practice. Heparin sodium and warfarin sodium are used alone or sequentially for primary and secondary prophylaxis in the management of a variety of thrombotic diseases. Bleeding complications associated with these agents are well-known; however, the risks and causes of paradoxical venous or arterial thrombosis occurring during anticoagulant therapy have only recently been elucidated. This article reviews the current understanding of serious acquired-prothrombotic states that can occasionally develop during treatment with anticoagulants. As background, a brief description of each drug's mechanism of action is first presented.

Anticoagulant Properties of Heparins and Warfarin

When given intravenously or subcutaneously, standard unfractionated heparin exerts its antithrombotic effect by first combining with antithrombin III, a native plasma inhibitor of coagulation. This interaction produces a conformational change that then dramatically enhances the efficiency with which antithrombin III . . . [Full Text of this Article]

Heparin-Induced Thrombocytopenia and Thrombosis

Coumarin Drugs and Thrombosis

Conclusions

Author Affiliation: Section of Hematology/Oncology, College of Medicine, Pennsylvania State University, Hershey.

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