Antithrombin

Um, those are, those are, those are anticoagulant proteins, right? So if you have that deficiency and you go on warfarin, uh, that almost like exaggerates that transient hypercoagulability you have, and that can put you in some deep, deep trouble, right? So you see a person having like tissue necrosis, skin necrosis after starting warfarin.

Uh, that's a very classic way to test protein C and protein S, uh, deficiency, right? Uh, and, uh, remember, right, the counterpart of warfarin, heparin, right? Remember heparin, uh, remember it supercharges antithrombin III, right? Antithrombin III is an anticoagulant protein.

Why do we say antithrombin III is an anticoagulant protein? Well, the thing it does is that it inhibits, uh, protein, uh, it inhibits factors II and X, right? Factors II and X.

Remember another name for factor II is, uh, thrombin, right? So it inhibits factor II and factor, factor X.

It inhibits those two clotting, clotting factors, right? So the thing that will happen there is when you supercharge antithrombin III to inhibit, uh, factors II and factor X, you're gonna exert an anticoagulant effect, right? So remember, heparin is great, right? It's, it's not a, it's not a teratogen, right? So that's amazing, right? But remember the association.

You see a person that starts heparin, and then you notice that, ooh, within a few days, boom, their platelet count, uh, decreases precipitously.

Usually, it's gonna decrease by more than fifty percent.