Bloody Minded Episode 75 - On the Wards: A Practical Guide to Anticoagulants | Part 1 (Basic Injectables)
Jan 20, 2026
Join haematologist Alison Chandler, a clinician-educator specializing in anticoagulation, as she unravels the mysteries of injectable anticoagulants. Discover why heparin can make your blood feel 'fat' and why the term 'blood thinners' is frowned upon. Alison explains unfractionated heparin’s mechanisms, monitoring challenges, and practical use on the wards. Plus, learn about low molecular weight heparin's advantages and dosing nuances in special populations, like during pregnancy. Get ready for a fascinating dive into the world of anticoagulation!
AI Snips
Chapters
Transcript
Episode notes
Always Check Baseline Bloods
- Get baseline blood tests before starting anticoagulation including FBC, EUC, LFTs and coagulation studies.
- Use these to check platelets, renal function and baseline coags so monitoring and agent choice are safe.
Pause And Ask Why You're Anticoagulating
- Before prescribing anticoagulation, ask why the patient needs it and weigh bleeding versus thrombotic risks.
- Check for contraindications like recent brain bleed or prior HIT before starting therapy.
How Heparin's Structure Determines Function
- Unfractionated heparin works by potentiating antithrombin to inhibit mainly factor Xa and thrombin.
- The pentasaccharide sequence gives anti-Xa activity while the long chain confers anti-thrombin function.