Anticoagulant, Antiplatelet and Fibrinolytic Drugs

Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues

“…The basic mechanisms of blood clot formation following injury/bleeding, and the attendant repair processes are illustrated in Figs. 1 and 2 [21,22].…”

“…Vascular injury and bleeding initiate a series of reactions that stop bleeding and maintain a normal balance within the system. These reactions include vasoconstriction, platelet aggregation, blood coagulation (clot formation), and clot resolution [21,22]. Although the initial vasoconstriction that follows blood vessel injury contributes to a reduction of bleeding, the cessation of bleeding ultimately depends on the formation of platelet plug and blood coagulation.…”

“…The creation of platelet plug involves initial adhesion and activation of platelets at the site of injury, followed by further activation and aggregation of platelet by released chemical mediators, such as adenosine diphosphate (ADP), platelet activating factor (PAF), serotonin, and thromboxane A 2 (TXA 2 ) (Fig. 1a) [21][22][23]. The platelet plug thus formed serves as a temporary/primary hemostatic plug [21][22][23].…”

“…1a) [21][22][23]. The platelet plug thus formed serves as a temporary/primary hemostatic plug [21][22][23]. As shown in Fig.…”

“…As shown in Fig. 1b, TXA 2 is formed from membrane phospholipids via arachidonic acid pathways involving various enzymes including cyclooxygenase-1 (COX-1) [21][22][23]. This component of the initial hemostatic process is a major target for the actions of many bloodthinning substances, including herbal supplements.…”