Each year thromboembolism affects millions of individuals worldwide.
As a result, anticoagulants are among the most commonly prescribed drugs in
clinical practice. Heparin sodium and warfarin sodium are used alone or sequentially
for primary and secondary prophylaxis in the management of a variety of thrombotic
diseases. Bleeding complications associated with these agents are well-known;
however, the risks and causes of paradoxical venous or arterial thrombosis
occurring during anticoagulant therapy have only recently been elucidated.
This article reviews the current understanding of serious acquired-prothrombotic
states that can occasionally develop during treatment with anticoagulants.
As background, a brief description of each drug's mechanism of action is first
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