{"id":6611,"date":"2024-11-18T12:06:14","date_gmt":"2024-11-18T12:06:14","guid":{"rendered":"https:\/\/workhouse.sweetdishy.com\/?p=6611"},"modified":"2024-11-18T12:06:15","modified_gmt":"2024-11-18T12:06:15","slug":"drugs-used-in-disorder-of-coagulation","status":"publish","type":"post","link":"https:\/\/workhouse.sweetdishy.com\/index.php\/2024\/11\/18\/drugs-used-in-disorder-of-coagulation\/","title":{"rendered":"Drugs used in Disorder of coagulation"},"content":{"rendered":"\n

Introduction<\/strong>
Hemostasis is spontaneous arrest of bleeding from a damaged blood vessel. Steps: Vascular
injury \u00c6 vasospasm\u00c6 platelate adhesion\u00c6 platelate aggregation \u00c6 coagulation cascades\u00c6
fibrin formation
Anticoagulants<\/strong> are the drugs which inhibit fibrin formation.
Classification<\/strong>
Based on mechanism of action<\/p>\n\n\n\n

    \n
  1. Fast and direct acting
    e.g: Heparin<\/strong><\/li>\n\n\n\n
  2. Slow and indirect acting<\/li>\n<\/ol>\n\n\n\n
      \n
    • Oral anticoagulants
      e.g Warfarin and Dicumarol
      Heparin<\/strong>
      It is a heterogeneous mixture of sulfated mucopolysaccharides
      Mechanism of action<\/strong>
      Heparin activates antithrobimin III (AT III) which inhibits clotting factor proteases and hence it
      inhibits the formation of fibrin clots, inhibits the conversion of fibrinogen to fibrin, and inactivates
      several of the factors necessary for the clotting of blood.
      Clinical Uses<\/strong>
      Prevention and treatment of venous thrombosis, atrial fibrillation with embolus formation,
      prevention of post operative thrombosis and embolism, in open heart surgery, in arterial
      embolus, treatment of coronary occlusion, acute myocardial infarction and peripheral arterial
      embolism
      Administration:<\/strong>
      Can be given IV or subcutaneous. Oral therapy is ineffective because it is inactivated by gastric
      acids and absorption is minimal because of large molecular size.Heparin must never be
      administered intramuscularly because of danger of hematoma formation at injection site.

      Side effects:<\/strong>
      Bleeding is the major side effect, allergy, alopecia, osteoporosis and thrombocytopenia
      Contraindications<\/strong>
      Contraindicated in patients who are hypersensitive to the drug, are actively bleeding or have
      hemophilia, thrombocytopenia, purpura, sever hypertension, intracranial hemorrhage, infective
      endocarditis, active tuberculosis, etc.
      ORAL ANTICOAGULANTS<\/strong>
      WARFARIN<\/strong>
      This compound was originally employed as a rodent poison. It is the most widely used coumarin
      anticoagulant and may be considered to be the drug of choice as an oral anticoagulant.
      Mechanism of action<\/strong><\/li>\n\n\n\n
    • The anticoagulant prevents reductive metabolism of the inactive vitamin K epoxide back
      to its active form
      Pharmacokinetics:<\/strong><\/li>\n\n\n\n
    • It is administered orally as sodium salt and has 100% bioavailability.<\/li>\n\n\n\n
    • The drug has slow onset of action, and long half-life in plasma (36hr) because 99% of
      the drug is bound to albumin.
      Clinical uses<\/strong>
      Prevention and treatment of deep vein thrombosis, treatment of atrial fibrillation with thrombus
      formation, prevention and treatment of pulmonary embolus, as part of the treatment of coronary
      occlusion and prevention of thrombus formation after value replacement
      Side effects<\/strong>
      Birth defect in pregnancy, hemorrhagic disease of newborn, hemorrhagic infarcts and
      cutaneous necrosis
      Contraindications <\/strong>\u2013 similar to heparin and the drug should never be administered during
      pregnancy.
      Drug interactions<\/strong>
      \u0083 The effect of warfarin will be increased when it is used with the following drugs.

      Cimitidine, dsulfiram, metronidazole, phenylbutazone, ASA and cephalosporin (3rd generations)<\/li>\n\n\n\n
    • The effect of warfarin will be decreased when it is used with the following drugs.
      Barbiturates, Cholestyramine, Rifampincin, Diuretics, vit K
      THROMBOLYTIC AGENTS<\/strong>
      Fibrinolytic agents rapidly lyse thrombi by catalyzing the formation of plasmin from plasminogen.
      All thrombolytic agents currently in use act directly or indirectly as plasminogen activators. The
      presently used plasminogen activators are:
      a. Streptokinase- a protein synthesized by streptococci, combines with plasminogen to
      convert it to active plasmin.
      b. Urokinase-human enzyme synthesized by the kidneys that directly converts plasminogne
      to active plasmin
      c. Anistreptase (Acylated plasminongen -streptokinase activator)- bacterial streptokinase
      plus human plasminogen
      d. Tissue plaminogen activator (tPA)-this activates preferentially plasminogen that is bound
      to fibrin.
      Indications:<\/strong>
      Multiple pulmonary emboli, central deep vein thrombosis and acute myocardial infarction.
      Adverse Reactions:<\/strong>
      Bleeding and allergic reactions are most common adverse effects thrombolytics.
      Contra-indications:<\/strong>
      Severe hypertension, recent cranial trauma and history of cerebrovascualr accident.
      ANTIPLATELET DRUGS<\/strong>
      Platelet function is regulated by three categories of substances<\/li>\n<\/ul>\n\n\n\n
        \n
      1. Agents outside the platelet that interact with platelet membrane receptors, e.g.
        catecholamines, prostacyclin<\/li>\n\n\n\n
      2. Agents generated within the platelets and interact with the membrane receptors, e.g.
        prostaglandin E2 and serotonin
        104<\/li>\n\n\n\n
      3. Agents generated within the platelet and act within the platelet, e.g. thromboxane A2 and
        calcium ions
        Antiplatelets act on any one of the above processes. They include aspirin, ticlopidine,
        dipyridamole.
        ASPIRIN (ASA)<\/strong>
        Thromoboxane A2 is an arachidonate product that causes platelet to change shape, to release
        their granules and to aggregate. Drugs that antagonize this pathway interfere with platelet
        aggregation and prolong bleeding time. Asprin at low dose is the prototype of this class of
        drugs. It inhibits the synthesis of thromboxane A2 by irreversible acetylation of the enzyme
        cyclo-oxygenase.
        Therapeutic Uses:
        Prophylaxis against myocardial infarction and prevention of stroke in patients at risk, e.g. those
        with transient ischemic attacks.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

        IntroductionHemostasis is spontaneous arrest of bleeding from a damaged blood vessel. Steps: Vascularinjury \u00c6 vasospasm\u00c6 platelate adhesion\u00c6 platelate aggregation \u00c6 coagulation cascades\u00c6fibrin formationAnticoagulants are the drugs which inhibit fibrin formation.ClassificationBased on mechanism of action<\/p>\n","protected":false},"author":1,"featured_media":6508,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[681],"tags":[],"class_list":["post-6611","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drugs-used-to-treat-the-diseases-of-blood-inflammation-and-gout"],"jetpack_featured_media_url":"https:\/\/workhouse.sweetdishy.com\/wp-content\/uploads\/2024\/11\/3606445.png","_links":{"self":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6611","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/comments?post=6611"}],"version-history":[{"count":1,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6611\/revisions"}],"predecessor-version":[{"id":6612,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6611\/revisions\/6612"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media\/6508"}],"wp:attachment":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media?parent=6611"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/categories?post=6611"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/tags?post=6611"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}