Anticoagulation. Current approach to heparin and warfarin therapy.

Anticoagulant therapy is required for a variety of indications. Heparin, usually administered intravenously, is the drug of choice for acute anticoagulation, with the infusion monitored by partial thromboplastin time. For long-term therapy the standard regimen includes heparin given via intravenous infusion for 7 to 14 days followed by oral warfarin therapy, monitored by prothrombin time. The duration of anticoagulant therapy depends on the indication for its use. The most serious complication with the anticoagulants is bleeding. Physicians should be aware of the risk factors for bleeding and of the measures capable of reversing the effects of the drugs.