The extreme complexity of the structure and function of the blood coagulation system is reflected not only in the difficulty of choosing methods and means of its correction, but also in the emergence of new challenges for clinicians. In particular, recent experience has shown that during the COVID-19 pandemic, approximately one-third of emergency admissions to intensive care units were for patients with thromboembolic complications. Unfortunately, we have to state that the preventive and therapeutic methods for the hemostasis system, recommended by various protocols, are general in nature. Moreover, they introduce dissonance into clinical clarity regarding the appropriate use of anticoagulants and antiplatelet agents and do not provide practicing physicians with the necessary fundamental knowledge to understand aspects of clinical tactics for correcting the hemostasis system. Questions regarding the correct choice of drug, as well as its effective dose, which must be calculated based on individual clinical and laboratory data, remain unclear. There are also difficulties associated with defining a clear list of laboratory markers of the blood coagulation system, with what exactly should be investigated in a particular situation; and with whether the results of the studies always reflect the true picture of the existing hemostasis. This article briefly outlines the main aspects of the blood coagulation system functioning, the application points and action mechanisms of the main pharmacological anticoagulant and antiplatelet agents. Recommendations are presented on effective and practical methods for assessing the hemostasis system state. Conclusion: The effectiveness of hemostasis system correction is based on a comprehensive understanding of the harmonious functioning of all its components, including the counterbalances of pro- and anticoagulation, points of application and action mechanisms of both pharmacological agents and blood components, as well as taking into account internal and external factors influencing the blood coagulation system homeostasis.

Keywords: review, anticoagulants, antiplatelets, thrombosis, hemostasis assessment, regulation.