History creating prophylaxis with coagulation modifiers

Anticoagulants

Medical procedures involving coagulation modifiers have occurred since ancient times. Hippocrates, an ancient Greek physician, noted surgical treatments with “oral blood thinners” in the 4th Century BC. Procedures known as “bloodletting” (removal of blood from the body) and Hirudotherapy that involve the use of were very common practices by Greek and Roman physician for over 4,000 years. Leeches, a hirudo species were used to treat an array of diseases but the therapeutic successes were later attributed to an anticoagulant compound within their saliva called hirudin. Medicinal accreditation for their use as an anticoagulant was proclaimed during the mid 1800’s. Despite that hirudin was found to be toxic when used as an extract in patients, the use of live leeches continues today in an array of therapies. A couple of major uses in surgical procedures are to restore blood flow to reconnected veins, and/or for the reattachment of body parts.

Treatments and surgeries for venous thromboembolism with anticoagulants date back to the late 1600’s. The first medically accredited anticoagulant was introduced in 1916. Jay McClean, a second-year medical student of Johns Hopkins University discovered the anticoagulant drug named Heparin which continues to be highly used today. The first oral anticoagulant termed dicoumarol (the predecessor to what is known today as Coumadin/warfarin) was introduced in 1939. The initial marketed use of warfarin was to exterminate rodents by causing profuse bleeding that resulted in the rodents death. The transition of warfarin from a poison to a therapeutic anticoagulant originated from an unsuccessful suicide attempt from its ingestion by a U.S. military soldier. Warfarin is now commonly prescribed to patients with elevated tendencies of developing thrombosis or as a prophylaxis for patients whom have already formed a clot to lessen their risks of VTEs.

http://www.leeches.biz/leech-approval.htm

http://www.vteconsultant.com/vteconsultant/VTE-prevention-understanding-current-strategies-The-Anticoagulant-Timeline.html


Antiplatelets

The use of antiplatelet therapy for VTE’s with aspirin transpired between the 1960s to the 1980s when it was clinically determined as having effective results in anti-clotting. Aspirin (acetylsalicicylic acid), the chemical result of a chemistry created reaction was officially discovered in 1853 by a French chemist named Charles Frederick Gerhardt. The history of aspirin dates back to 400 BC when Hippocrates was known to prescribe willow tree bark and leaves for the treatment of fever and pain. Through clinical studies, aspirin eventually acquired its name and was officially marketed by the Bayer drug and dye firm in 1899. The advancements in chemical technology led to the scientific discovery that aspirin also had an anti-clotting effectiveness on platelets in its inhibition of the prostaglandin thromboxane. The inhibiting of platelet aggregation has significantly reduced the risks of unwanted blood clots and moreover reduced the risks of life-threatening VTEs. The use of aspirin as a VTE prophylaxis following surgeries amplified dramatically from that point and continues today.

http://www.wonderdrug.com/pain/asp_history.htm


Thrombolytics

Procedures involving thrombolysis are the most modern in therapeutic care for patients that produce VTEs. The historical development of these medications originates from the 1930s when Tillett, and Garner at Johns Hopkins Medical School discovered thrombolytics ability to dissolve existing fibrin clots in Streptococcus bacteria. By 1956, E. E. Clifton from Cornell University Medical College in New York successfully treated numerous patients for blocked blood vessels, arteries, or veins (thrombi occlusions) with SK-plasminogen. This accomplishment lead to what we know as thrombolytic therapy today “clot busting” (to initiate the dissolution of blood clots) that legitimately began in the 1990s for conditions such as VTEs. The concern that arose with these medications was the extent of dissolution these drugs were capable of that could lead to hemorrhaging. Nevertheless, through years of research and trials these medications have proven that the efficacious use substantially outweighs the risk of ischemic deaths.

http://enth.allenpress.com/enthonline/?request=get-document&doi=10.1583%2F04-1340.1