Tumor patients encounter venous thrombosis, anticoagulant families show their magical powers

The "Tumor Kingdom" is a restless country that likes to stir up trouble. This time, the King of the Tumor Kingdom is plotting how to block the main traffic arteries of the "Human Kingdom" - the veins. Look, the Tumor King plans to use three tricks to launch a "venous thrombosis war"...

Three steps to launch the "battle against venous thrombosis"

The first trick: slow blood flow

Blood flow is slowed down by tumor compression of blood vessels or long-term bed rest. The second trick: hypercoagulation of blood is achieved by secreting various procoagulant factors. The third trick: damaged blood vessels are damaged by chemotherapy drugs, intravenous catheterization, etc. All three tricks will form venous thrombosis. In the early stage, the thrombus stays in the limb veins, which may only cause local redness, swelling and other discomfort, but as the thrombus progresses, the thrombus breaks off and flows to the lungs with the blood, which can cause pulmonary embolism, and in severe cases, death!

Three anticoagulant experts volunteered to fight against venous thrombosis

The Human King is not afraid of the provocation of the Tumor King: "I have many beloved anticoagulant generals, the Tumor King will never succeed!"

Three generals of the human nation volunteered to go to the battlefield.

Anticoagulation veteran

Warfarin

Features:

Battle-tested, with rich anticoagulation experience;

Oral administration, slow onset of effect (maximum efficacy in 3 to 4 days);

The anticoagulant effect is easily interfered by food and drugs;

Blood draw is required to monitor the anticoagulation effect (INR monitoring).

Anticoagulation General

Low molecular weight heparin

Features:

A victorious general in the anticoagulation field with rich anticoagulation experience;

Subcutaneous injection, rapid onset of action;

Need to cooperate with fixed partner "Antithrombin".

Anticoagulant Rising Star

Rivaroxaban

Features:

He has made outstanding military achievements and is a breath of fresh air in the anti-coagulation world;

Oral administration, rapid onset of action;

No need for a partner, can fight alone;

Few food-drug interactions;

The anticoagulation effect is stable and no monitoring is required.

Anticoagulant tactics help the army win

The three anticoagulant soldiers each have their own characteristics. How should we deploy troops to fight and win the "battle of venous thrombosis"?

Let's listen to the "Anticoagulant Pharmacist" to analyze the "Anticoagulant Art of War"······

If you encounter tumor-related venous thrombosis, who is the best person to send?

Rivaroxaban and low molecular weight heparin can be used because they have more evidence-based medicine for the treatment of tumor-related venous thrombosis and have better anticoagulant effects.

If a gastric cancer patient encounters blood clots, who can achieve the goal of better results and less bleeding?

It should be low molecular weight heparin. Because rivaroxaban has a high risk of gastrointestinal bleeding in patients with gastroesophageal tumors, it is not suitable for use.

If a cancer patient has renal failure, who can be sent to fight?

Warfarin can be administered. Warfarin is almost completely metabolized by the liver into components without anticoagulant activity and is independent of the kidneys. Therefore, the use of warfarin in patients with renal failure will not lead to its accumulation in the body and will not increase the risk of bleeding.

Low molecular weight heparin is used flexibly (half therapeutic dose). The current anticoagulation regimen recommended by the 2021 NCCN Guidelines for Tumor-Related Venous Thrombosis is enoxaparin 0.5 mg/kg, twice a day.