Warfarin and acenocoumarol are the two main drugs currently available in our country although there are other VKCF antagonists (VKA) with different pharmacodynamic yet leading to the same effect. The determination of INR with ready and easy-to use coagulometers has lead throughout the last twenty years to the decentralization of controlling these patients towards their nearest environment: primary care (or prison healthcare in this case). The first to be used were those inhibiting the synthesis of Vitamin K -dependent clotting factors (VKCF) since they enabled a delayed formation of the thrombus. Since the 1950s, oral anticoagulation therapy (OAT) has become the cornerstone of the prevention and treatment of thromboembolic disease in different favoring clinical contexts. Key words: prisons atrial fibrillation thromboembolism primary health care therapeutics Spain disease prevention anticoagulants. This article reviews the different indications of oral anticoagulant therapy according to the new recommendations as well as the clinical scenarios in which it should be used. The emergence of new therapeutic alternatives (Dabigatran, Rivaroxaban, Apixaban and Edoxaban, the so called "ACOD") has permitted the expansion of options for oral anticoagulation in some cases, since they do not require systematic monitoring of their effect and interact with far fewer drugs than their predecessors, although there are still restrictions by the health authorities on their widespread use.
HAIM DAYS ARE GONE VK PORTABLE
The possibility of obtaining the INR by portable coagulometers has allowed primary care physicians to tackle the indication of this therapy and the control of these patients in coordination with haematology services. Younger populations, such as those in prisons, often require this treatment for reasons other than atrial fibrillation, often in relation to valvular or congenital or acquired hypercoagulability situations. Oral anticoagulant therapy is currently widespread in the population and primary care plays an important role in its control in Spain. Members of the Anticoagulation in Primary Care Task Force of the Societat Catalana de Medicina Famíliar i Comunitària (CAMFIC) Anticoagulación oral en Atención Primariaġ Family Physician in Poble Sec/Montjuïc (Barcelona), SpainĢ Family Physician in Figueres (Girona), España.