Doctors spoke about the dangers of blood-thinning drugs

Famous actor Stanislav Sadalsky ended up in the hospital due to hemorrhage, which he attributes to taking a blood-thinning drug after suffering from covid. It is known that COVID-19 often becomes a risk factor for the development of thrombotic complications, therefore, drugs from the group of anticoagulants and antiplatelet agents have been prescribed to patients much more often in the last three years - and not only by doctors, but also by themselves. About how dangerous it is, learned "MK".

As Sadalsky told users on the social network, on Tuesday night he was “taken to the hospital by ambulance, I sin on experiences, the death of friends, on blood-thinning drugs, xarelto 20 mg, lemons, ginger ... until the bleeding was stopped.” In particular, the actor sins on the drug xarelto, an anticoagulant often prescribed for coronavirus infection.

Whether the blood-thinning treatment was prescribed to the actor by a doctor, or whether his admission is his own initiative, is not specified. Nevertheless, during the pandemic years, the demand for such drugs has increased significantly. Many people, having read articles on the Internet, began to apply them on their own. However, doctors have repeatedly said that this practice is very dangerous.

“For those who do not understand, doing anticoagulants at home is not only pointless, but also dangerous. But naive citizens cannot be persuaded, ignorant doctors cannot be retrained,” says Leonid Averbakh, a well-known ambulance doctor from St. Petersburg. — No need to think, just remember and tell yourself and those who will recommend them to you: no. There are no home anticoagulants available to prevent or treat mild forms of COVID-19. By the way, and after an extract from a hospital too. There are contraindications, consult your doctor. But if you are taking anticoagulants for other conditions, keep taking them.”

Doctor-cardiologist of the highest category, candidate of medical sciences, associate professor of the Department of Faculty and Polyclinic Therapy at Sechenov University Anton Rodionov calls the appointment of anticoagulants for mild cases of covid "thoughtlessly crazy." In his social network, he says that today many doctors prescribe blood thinners just in case: “One of the manifestations of covid panic was the massive prescription of anticoagulants to everyone whose clinical picture even remotely resembles covid, regardless of manifestations, age, severity of the condition, kidney function, etc. .d. Sometimes patients do this on their own, having read one outstanding hematologist with an overvalued anticoagulant dominant. “So what are you against anticoagulants?!” listeners immediately ask, having barely heard doubts about the mindlessly-crazy prescribing of these drugs to everyone in a row. It is somehow strange to explain that any medicine is a double-edged thing, one for the benefit, the other to the detriment, that there is no panacea one for all, that there are indications and contraindications.

At the same time, Dr. Averbakh clarifies that it is very difficult to distinguish covid and other acute respiratory viral infections, including influenza, by symptoms. However, they require a completely different approach to treatment. And if in one case anticoagulants can help, then in another they can frankly harm: “When a patient does not know which virus has overtaken him, the flu or the “corona”, it is categorically not recommended to prescribe any drugs to yourself. Knowing firsthand about the love of the people for self-treatment, I think that it is necessary to call a doctor if you get sick and your condition is not very good. If a complication such as thrombosis / thromboembolism is more typical for covid, and after laboratory diagnosis, blood-thinning drugs are sometimes recommended, then a possible complication from influenza is thrombocytopenia (a decrease in the number of platelets responsible for blood clotting), that is, on the contrary, bleeding or bleeding is possible (hemorrhage). Blood clotting disorders are a serious complication, and taking anticoagulants for influenza, as well as, in principle, their overdose, can lead to bleeding. And the bleeding will already have to be fought in the hospital. ”

And yet, as Dmitry Napalkov, Doctor of Medicine, Associate Professor, Professor of the Department of Faculty Therapy No. 1 of Sechenov University, Dmitry Napalkov, told MK, doctors today do not encounter side effects of anticoagulant therapy so often: “But in any case, self-medication with this group of drugs is unacceptable! They should be prescribed only by a doctor and according to indications. I can say that, fortunately, I almost never see doctors prescribing anticoagulants for covid without indications, this is already some kind of casuistry, almost no one does this now. And serious complications after them are quite rare.

- Is there frequent bleeding while taking such therapy?

- Any drug that affects the blood coagulation system can cause bleeding. Therefore, do not forget to visit your doctor periodically if you are taking such medicines, so that he checks how effective and safe the treatment is. You can, for example, cut your fingers while taking such drugs - and there will be heavy bleeding, not fatal, but not easy either. However, spontaneous or unprovoked bleeding on modern blood thinners is rare.

Is it acceptable to take prophylactic anticoagulants for covid?

- With covid, such drugs can be prescribed only after discharge from the hospital and only after a severe course. In the outpatient setting, patients do not require anticoagulants.

- Previously, they were distributed free of charge to all outpatients. Not now?

- Now there is no such practice. And in general, it is not recommended to start the use of anticoagulants for those who are not hospitalized without indications.

Published in the newspaper "Moskovsky Komsomolets" No. 28957 dated January 25, 2023

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