Anticoagulants Antiplatelets and Antifibrinolytics

Coagulopathy refers to an abnormal state of hemostasis. The incidence of coagulopathy in neurocritical care is described variedly between 14 and 80% and affects the prognosis of acute brain injury—trauma and stroke. Management of coagulopathy requires a good understanding of the physiology of hemostasis, the pharmacology of various drugs available, and the reversal mechanisms available. Hemostasis can be explained by the classical and the cell-based model. The former emphasizes the role of platelets, coagulation cascade, and fibrinolysis. This chapter provides an overview of the major drugs that inhibit these factors, namely the antiplatelets, anticoagulants, and the antifibrinolytic agents and its relevance to the neurocritical care setup.