Question

Mr. Arnold is a 54-year-old male admitted with an acute myocardial infarction. His treatment plan includes aspirin 325 mg chew and swallow and an IV infusion of heparin and alteplase (Activase) to infuse over 2 hours.

Explain why Warfarin ( coumadin) was not used to treat this patient.

Answer 1

The alteplase (Activase) a major thrombolytic agent functioning as the plasminogen activatoin is the best recommended drug of choice in the management of the acute myocardial infarction. It is supplemented with the heparin infusion within the 3 hours.The warfarin is not used in this patient along with the altepase as it is having mild contraindication with it. Because the altepase converts plasminogen to plasmin to degrade the thrombus. while the warfarin inhibits carboxylation of vitamin K based clotting factors for the example clotting factors  II, VII, IX & factor X and thus the warfarin makes these factors inactive which is not desired in this case.