By inactivating thrombin, heparin not only prevents fibrin formation but also inhibits thrombin-induced activation of platelets.

It produces its major anticoagulant effect by inactivating thrombin and activated factor X (factor Xa). Heparin and its derivatives are the most widely used parenteral anticoagulants in the UK, for the treatment and prophylaxis of thrombo-embolic disease. Parenteral Anticoagulants Heparins/Fondaparinux Apixaban and fondaparinux) or are usually monitored using indirect tests (Dabigatran). Whereas UFH, LMWH, and warfarin therapy all can be monitored using either indirect or more specific quantitative assays, many of the novel anticoagulants are either not routinely monitored (e.g. The use of novel anticoagulants is complicated by a lack of easily available laboratory tests to measure their levels and thereby optimize their clinical benefit and safety. Transfusion packed red cells, platelets, etc.Local or surgical Haemostatic measures also agents like tranexamic acid.Supportive treatment volume resuscitation and inotropic support.Hold further doses of the anticoagulant.The general principles for the management of haemorrhage in the anticoagulated patient detailed using the mnemonic:

Warfarin vitamin k antidote