Let's learn about a new type of medication that prevents blood clotting? (Direct Thrombin Inhibitors)

Did you know that the blood that flows through your veins can sometimes clot unnecessarily? If such a blood clot goes to the brain, it can cause a stroke, and if it goes to the heart, it can cause a heart attack. So today we are going to talk about a special type of medication that doctors use to prevent these dangerous conditions. These are called Direct Thrombin Inhibitors.

Simply put, what are these Direct Thrombin Inhibitors?

These are a class of drugs that prevent blood clotting. They are what we usually call "blood thinners." But the way they work is a little different. The idea for making these drugs is based on a protein found in the saliva of leeches. You may have heard that leeches were also used for medical treatment in the past.

Most people in the world die from heart disease. The main reason for that is blood clots. So doctors prescribe drugs like this to save people from this risk.

What conditions is this medicine used for?

This class of drugs, called direct thrombin inhibitors, is often used to prevent or treat blood clots caused by various medical conditions. Let's take a look at what they are.

Additionally, you may be given this medication during treatments such as angioplasty, which opens up the arteries in the heart.

What medications belong to this category?

There are several types of direct thrombin inhibitor drugs that are currently commonly used in Sri Lanka and the world.

• Argatroban (this is given as an IV injection)
• Bivalirudin (this is also given as an intravenous injection - IV injection)
• Dabigatran (this is what you take as a pill)

How does this medicine work inside the body?

Very simple. As the name suggests, this drug goes straight to and inactivates an enzyme called Thrombin.

Now you may be asking what this Thrombin is. Simply put, Thrombin is a key factor in the blood clotting process in our body. It's like the main chef preparing a meal. What this medicine does is to hold that chef aside. Then the blood clotting process doesn't happen properly. So the formation of unnecessary blood clots stops. Do you understand?

But sometimes this medicine can cause increased bleeding. There is a special injection that can reverse the effects of the pill Dabigatran. It is called `Idarucizumab`. However, there is no special antidote for the intravenous medicine. However, once the medicine is stopped, its effects will wear off after a while.

How long do I need to take this medicine?

It varies from person to person. Some people only need to take it for a short period of time, like a month after hip replacement surgery. But someone who is at a much higher risk of blood clots may need to take this medication for the rest of their lives . Your doctor will decide exactly what to do.

What are the advantages of this type of medicine?

This new class of drugs has several advantages over older drugs.

• The results are the same: Since these only directly affect Thrombin, you can expect the same results from the same dose every time.
• No decrease in platelets: Unlike some older medications, these do not lower the level of platelets, which help blood clot.
• You don't need to have your blood tested frequently: Some medications, like Warfarin, require regular blood tests to check how quickly your blood is clotting. But this medication doesn't require that.
• Fewer side effects: Dabigatran, which is taken as a pill, has a lower risk of bleeding and interactions with other medications when compared to Warfarin.
• Easy to use: It is very easy to use as you only have to take a pill once or twice a day.
• Another option: These are a good option for those who cannot use medications like Heparin.

How effective is this medication? And what are the risks?

Research has found that this medication is as safe and effective as Warfarin or Heparin. However, they are not as suitable for people with certain heart valve diseases.

What does this mean? You can't miss a single day of taking this medicine. If you miss a single day of taking it, your risk of developing a blood clot increases dramatically.

Possible side effects

Like any medication, this one can have side effects, some of which can be serious.

When should I see the doctor?

If you experience any side effects while using this medicine, inform your doctor immediately.

In particular, if you are bleeding excessively (for example, if you cannot stop bleeding from a wound, if you have blood in your stool, if you have a nosebleed that is causing you to have a concussion) or if you have other serious symptoms (severe chest pain, difficulty breathing), go to the nearest hospital Emergency Department (ETU) without delay.

Finally, there is no need to be afraid of developing a blood clot. Modern drugs like direct thrombin inhibitors can control that risk to a great extent. But your doctor will decide which medication is best for you and how long you should take it. So always follow your doctor's advice.