Abstract
The history of oral anticoagulants started in the 1920s in North Dakota and Alberta
when a new type of hemorrhagic disease struck cattle in these areas. The group of
Karl Paul Link finally succeeded in isolating the causative agent, dicumarol. It was
not before the 1940s, that dicumarol or its derivatives were introduced to medicine.
Acenocoumarol, phenprocoumon, and warfarin are the most commonly used oral anticoagulants.
There is no known difference in the pharmacodynamic activity of these agents on the
vitamin K metabolism. They are completely absorbed from the gastrointestinal tract
and are firmly bound to plasma albumin and metabolized in the liver. The different
elimination half-lives of the coumarins have several implications for patient management.
Absorption, protein binding, and anticoagulant activity of oral anticoagulants are
affected in many different ways. Also the different pharmacological properties of
coumarins require different strategies in the clinical management of patients.
Keywords:
Coumarin - warfarin - pharmacological properties - oral anticoagulants - vitamin K
