BA4F04 Blood Clotting Cascade Affected by Warfarin Level 4

Body

Blood clots are health and lifesaving when they stop bleeding. But they can also form when they aren't needed and cause a heart attack, stroke, or other serious medical problems. To prevent blood clots in lethal areas, Warfarin has been prescribed by the health care professionals (Sekhri and et.al., 2016). The medicine possesses some side effects which can impact on body negatively. Warfarin is an antagonist for Vitamin K and can only be administered orally. It blocks the functions of vitamin K dependent clotting factors (II, VII, IX, X) (Leite, Martins and Castilho, 2016). The goal of warfarin therapy is to minimise the blood clots in critical areas. It is important to monitor the effect of warfarin carefully with blood testing. In order to maintain homeostasis, the endocrine system of body plays crucial role. As hormones regulate the activity of body cells, the endocrine system of body helps in maintaining homeostasis. The clotting Factors (II, VII, IX, X) has been identified due to Warfarin (Graham and et.al., 2015). The name of these factors are described below in the table:

Clotting can occur through two different pathways which are intrinsic pathway and extrinsic pathway. Due to internal bleeding, clotting can occur through intrinsic pathway and due to release in tissue factors due to physical injury clotting occur through extrinsic pathway (Bouchnita and et.al., 2016).

From the above image it can be understood that the suppression of the Factors II (Prothrombin), VII, IX and X have an effect on the establishment of a stable fibrin clot. There is direct effect of extrinsic pathway due to suppression of Factor VII (Siegmund and et.al., 2016). By suppressing the factor the whole pathway can be blocked. Intrinsic pathway can be affected due to inhibition of Factor IX and X. Factor X has a double effect on the extrinsic pathway because if there is still some factor VII in the blood stream it will have no factor X to react with. Thus, it is essential for the health care professionals to monitor the effect of warfarin in patient through blood testing effectively.

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REFERENCES

• Bouchnita, A., Bouzaachane, K., Galochkina, T., Kurbatova, P., Nony, P., & Volpert, V. (2016). An individualized blood coagulation model to predict INR therapeutic range during warfarin treatment.Mathematical Modelling of Natural Phenomena,11(6), 28-44.
• Graham, E. J., Hood, K., Ma, Y., Radunskaya, A., & Simons, J. (2015). Injury-initiated clot formation under flow: a mathematical model with warfarin treatment. InApplications of Dynamical Systems in Biology and Medicine(pp. 75-98). Springer, New York, NY.
• Holland, G. C. (2016).The Effect of Acute Exercise on Coagulation Factors and the Mechanical Properties of Fibrin Fibers(Doctoral dissertation, Wake Forest University).
• Leite, P. M., Martins, M. A. P., & Castilho, R. O. (2016). Review on mechanisms and interactions in concomitant use of herbs and warfarin therapy.Biomedicine & Pharmacotherapy,83, 14-21.
• Sekhri, A., Lisinschi, A., Furqan, M., Palaniswamy, C., Mukhi, N., Gupta, R., & Nelson, J. C. (2016). The Conundrum of “Warfarin Hypersensitivity”: Prolonged Partial Thromboplastin Time From Factor IX Propeptide Mutation.American journal of therapeutics,23(3), e911-e915.
• Siegmund, H. U., Burghaus, R., Kubitza, D., & Coboeken, K. (2015). Contribution of rivaroxaban to the international normalized ratio when switching to warfarin for anticoagulation as determined by simulation studies.British journal of clinical pharmacology,79(6), 959-966.

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