ABSTRACT
Health care providers who treat patients with anticoagulants should have a complete understanding of the clinical pharmacology of each of the drugs. This chapter focuses on the kinetics and dynamics of the two most commonly used anticoagulants, heparin and warfarin. The relationship between intensity of oral anticoagulant therapy and clinical effectiveness, including bleeding complications, has been evaluated. Target ranges for oral anticoagulation therapy are best described in terms of the international normalized ratio, since this eliminates the major laboratory-to-laboratory differences in prothrombin time results, namely the sensitivity of the thromboplastin being used. White and Mungall conducted a randomized trial to compare the abilities of an anticoagulation nurse specialist to computer-assisted dosing in 50 outpatients on chronic warfarin therapy. Heparin is an anticoagulant that has been used for treatment of thromboembolic conditions. The anticoagulant activity of intravenously administered heparin has been described as a single exponential curve.
