Acenocoumarol

Sinthrome tablets contain the active ingredient acenocoumarol which is a type of

medicine called an oral anticoagulant. It is used to stop blood clots forming within the blood
vessels.
Blood clots normally only form to stop bleeding that has occurred as a
result of injury to the tissues. The clotting process is complicated and begins when
blood cells called platelets clump together at the site of damage and produce
chemicals that activate clotting factors in the blood. Clotting factors are proteins
that are produced by the liver. Vitamin K is essential for their production. The
activated clotting factors cause a protein called fibrinogen to be converted into
another called fibrin. Fibrin binds the platelets togeth er, forming a blood clot. This
is the body'’s natural way of repairing itself.

Acenocoumarol is a coumarin derivative used as an anticoagulant. Coumarin

derivatives inhibit the reduction of vitamin K by vitamin K reductase. This prevents
carboxylation of vitamin K-dependent clotting factors and interferes with coagulation.
Hematocrit, hemoglobin, international normalized ratio and liver panel should be monitored.
Patients on acenocoumarol are prohibited from giving blood.

Acenocoumarol is prescribed to prevent unwanted clots from forming if you have

a condition that puts you at risk of this happening, such as atrial fibrillation, or if you have
had a heart valve replacement. It is also given to prevent any clots that may have already
formed in the blood vessels of your legs, lungs or heart from becoming larger and causing
problems.

Acenocumarol is widely used in long-term anticoagulant treatment. Overdose of

this drug may result in suffusions in various parts of the body. In three cases, we observed
suffusion in the rectus sheath, which is an unusual site of hematomas. At early stage, the
lack of discoloration of the abdominal wall may lead to problems in differential diagnosis.

Chronic anticoagulant treatment in a patient's history in combination with a

palpable abdominal mass facilitate the correct diagnosis. In addition, high INR also makes
hemorrhagic complications more likely. In simple cases, suggestive past medical history,
abdominal palpation, INR and ultrasound examination can be sufficient to make a
diagnosis. However, in more complicated cases, further assessment by CT is required to
set up the diagnosis; while, in a further case discussed in this article, we could only
establish an accurate diagnosis with laparoscopy. Decreased plasma prothrombin levels
were always normalized with vitamin K.

Acenocoumarol works by partially blocking the reuse of vitamin K in your liver.

Vitamin K is needed to make clotting factors that help the blood to clot and prevent
bleeding. Vitamin K is found naturally in foods such as leafy, green vegetables and certain
vegetable oils.
 As acenocoumarol works by inhibiting the action of vitamin K, changes to
your dietary intake of vitamin K can alter the effect of your acenocoumarol. For this
reason, avoid making sudden major changes to your diet, particularly your
consumption of green tea, salad and green vegetables (eg broccoli, brussel
sprouts, or spinach), which contain large amounts of vitamin K. Large amounts of
green vegetables can reduce the effect of acenocoumarol and should be avoided.
Changes to your consumption of fats and oils can also alter the effect of
acenocoumarol, as vitamin K is a fat soluble vitamin.

Side effects of acenocoumarol can be dangerous; it can cause uncontrollable

bleeding as well as internal bleeding with no apparent cause. Patients should be careful to
avoid cutting or injuring their skin and should be alert to the signs and symptoms of internal
bleeding such as abdominal pain and swelling, bloody waste products or vomit, dizziness,
fainting, blurred vision, sudden weakness, or confusion. It these problems are suspected,
immediate medical attention is required. Other mild side effects include loss of appetite,
stomach discomfort, cold intolerance, and temporary hair loss.