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clotting component/factor - target of action
II (prothrombin) -
VII (proconvertin) -
IX (stuart-Prower factor) -
Protein S & C -
Plasminogen -
II (prothrombin) - heparin, dabigatran, warfarin
VII (proconvertin) - warfarin
IX (christmas factor, PTC) - warfarin
x (stuart-Prower factor) - heparin, warfarin, rivaroxiban, apixaban, edoxaban
Protein S & C - warfarin
Plasminogen - thrombolytic enzymes, aminocaproic acid
heparin vs. warfarin
structure -
administration -
site of action -
onset -
mechanism -
monitoring -
antidote -
use -
pregnancy -
heparin vs. warfarin
large acidic | small, neutr
polysaccharide | lipid-soluble
parenteral | oral
rapid | slow
+ antithrom III | - post-trans mod F 2,7,9,10
aPTT (unfract) | prothrombin time
protamin (unfrct) | Kvit, plasma, prothrombin
acute | chronic
yes | no
Which drug combination?
for revascularization
heparin + thrombolytics
which drug combination?
angioplasty prep
coronary stent placement prep
heparin + glycoprotein IIb/IIIa inhibitors
anticoagulant toxicities
heparin (aPTT) - bleeding, transient thrombocytopenia, osteoporosis
direct thrombin inhibitors (aPTT) - bleeding
direct factor Xa inhibitors (-) - bleeding
warfarin (PT) - bleeding, hyPERcoagulability w/ dermal necross due to Protein S&C
tissue plasminogen activator toxicities
bleeding
streptokinase induced allergy
mechanism of anticlotting drugs:
anticoagulants - inhibit fibrin clot formation
thrombolytics - increase plasminogen to plasmin activation
antiplatelet drugs - decrease platelet aggregation
In case of bleeding due to heparin toxicity give ...
protamine
clotting drugs are used in case of
thrombocytopenia
vitamin K deficiency
genetical clotting problems (hemophilia)
drug-induced conditions
... is a thrombopoietic stimulating factor that is used as clotting drug
oprelvekin
... is antidote for warfarin toxicity
Vitamin K | Phytonadione (vitamin K1)
anticlotting drugs
clotting drugs
anticlotting drugs
a. anticoagulants
heparin
direct thrombin inhibitor
direct factor Xa inhibitor
warfarin
b. Thrombolytics
tPA derivativea
streptokinase
c. Antiplatelet drugs
Aspirin
Glycoprotein IIb/IIIa inhibitors
PDE/adenosine uptake inhibitors
clotting drugs
a. Replacement factors
b. Vitamin K
c. Antiplasmin drugs
d. Performed clotting factors
e. Platelet administration
f. Oprelvekin administration
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