ANTI - HEMOSTATIC DRUGS

• ANTI THROMBOTIC

• THROMBOLYTIC DRUGS

• ANTI COAGULANTS

ANTI THROMBOTIC• Anti platelet drug• Aspirin-Low dose (80-160 mg)• • Ticlopidine• Clopidogrel

• Mab –

• Dipyridamole • Pentoxiphylline

Dipyridamole

(-)

Platelet activation

Pentoxiphylline

• Xanthine analogue

• Increases deformability of RBCs thus increases microcirculation, reduce fibrinogen levels, inhibit pl. aggregation.

• Uses-CVAs esp.TIA(transient ischemic attacks) , Ischemic ulcers of legs

Anti fibrinolytic

• Streptokinase• • Staphylokinase

• Alteplase=t-PA

• Reteplase =U-PA

• Tenecteplase

ANTICOAGULANTS

ENDOGENOUS EXOGENOUS

ANTICOAGULANTS

ENDOGENOUS

1. HEPARIN2. ANTOTHROMBIN III3. PROTEIN C4. α2 MACROGLOBULIN

EXOGENOUS

1. HEPARIN2. VIT K ANTAGONISTS3. Ca SEQUESTERS4. DEFIBRINATION

SUBSTANCES5. COLD6. HIRUDIN

ANTICOAGULANTS

• FOR BLOOD COLLECTION

• FOR TREATMENT

ANTICOAGULANTS

• FOR BLOOD COLLECTION

1. HEPARIN2. Ca SEQUESTERS3. COLD

• FOR TREATMENT

• HEPARIN

CALCIUM SEQUESTERS• MOA

• OXALATES• CITRATE • TRISODIUM CITRATE• EDTA• SODIUM FLUORIDE• HEPARIN

OXALATES• Acts by insoluble salts with calcium in blood to

ppt Ca • Ammonium :Potassium oxalate =2:3

• 2mg/dl

• Uses • PCV• ESR

CITRATE

• Acts by deionisation of calcium in blood

• Blood banks• ACD• CPD• CPD-A

• 0.4 ml Na citrate in 1.6mlof blood

TRISODIUM CITRATE

• 3.8%

EDTA

• Sequester or chelating effect on calcium

• 1mg/dl

• ESR• PT

• Uses- routine blood tests

Three types of EDTA salt – sodium potassium lithiumDipotassium salt more soluble than Disodium salt, hence preferred

SODIUM FLUORIDE

• deionisation of calcium in blood

FIBRINOGENPTPTTESR(by westergren method)

USES

COLD

• 5-10 0C

ANTICOAGULANTS FOR TREATMENT

ORAL

VIT K ANTAGONISTS

PROTEIN C

VITAMIN K ANTAGONISTS• COUMARIN DERIVATIVES- DICOUMAROL

• WARFARIN

• PHENINDIONE

VITAMIN K

• SOURCES:

Causes of deficiency• Obstructive jaundice• New born babies• c/c diarrhoea• Side effect of antibiotic

VITAMIN K

• II• VII• IX• X• PROTEIN C• PROTEIN S

HEPARIN

PARENTERAL- I V OR S/C

• COLD-5-10 0C

• HIRUDIN –leech-anti thrombin

• DEFIBRINATION SUBSTANCES

• Malaysian pit viper venom

Hemostatic drugs

• INHIBIT FIBRINOLYTIC SYSTEM

• COAGULATION SYSTEM

• CAPILLARY INTEGRITY

• VASOCONSTRICTORS

• WOUND SEALING AGENTS

INHIBIT FIBRINOLYTIC SYSTEM

• Eaca• Transexemic acid• aprotinin

COAGULATION SYSTEM

• vit k• Botropase

CAPILLARY INTEGRITY

• Ethamsylate adrenochrome• Vitamin c

VASOCONSTRICTORS

• Somatostatin• adrenaline

WOUND SEALING AGENTS

• feracrylum