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An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombotic disorders. Some chemical compounds are used in medical equipment, such as test tubes, blood transfusion bags, and renal dialysis equipment. Three primary ways to prevent coagulation medically currently exist:

Coumarines (Vitamin K antagonists)

The oral anticoagulants are a class of pharmaceuticals that act by antagonizing the effects of vitamin K. As the K vitamins are required for proper blood clotting, clotting is prevented. Available agents include:

* Warfarin (Coumadin), this is the main agent used in the U.S. and UK. * Acenocoumarol and phenprocoumon, this is used more commonly outside the U.S. and the UK * Brodifacoum, a rat poison, not used medically * Phenindione Heparin and derivative substances

Heparin is a biological substance, usually made from pig intestines. It works by activating antithrombin III, which blocks thrombin from clotting blood.

Direct thrombin inhibitors

Direct thrombin inhibitors (DTIs) are a class of medication that act as anticoagulants by directly inhibiting the enzyme thrombin. Some compounds include:

* Hirudin * Bivalirudin, transient inhibition - is cleaved by thrombin * Lepirudin * Desirudin * Argatroban * Melagatran, and its prodrug ximelagatran * Dabigatran

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