BLOOD COAGULATION AND ANTICOAGULANT, THROMBOLYTIC… · 9/20/2012 1 BLOOD COAGULATION AND...

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9/20/2012 1 BLOOD COAGULATION AND ANTICOAGULANT, THROMBOLYTIC, AND ANTIPLATELET DRUGS Alfi Yasmina Dea Arie Kurniawan Antikoagulan, Antitrombotik, Trombolitik, Hemostatik Beberapa Istilah Hemostasis Koagulasi Trombosis Antikoagulan Antitrombotik Trombolitik Hemostatik

Transcript of BLOOD COAGULATION AND ANTICOAGULANT, THROMBOLYTIC… · 9/20/2012 1 BLOOD COAGULATION AND...

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BLOOD COAGULATION AND

ANTICOAGULANT,

THROMBOLYTIC, AND

ANTIPLATELET DRUGS

Alfi Yasmina

Dea Arie Kurniawan

Antikoagulan, Antitrombotik, Trombolitik,

Hemostatik

Beberapa Istilah

• Hemostasis

• Koagulasi

• Trombosis

• Antikoagulan

• Antitrombotik

• Trombolitik

• Hemostatik

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• Indirect Trombin Inhibitor

– Heparin

– Warfarin

– Rivaroxaban

• Direct Trombin Inhibitor

– Bivalirudin, Hirudin, Lepirudin,

Argatroban

– Dabigatran, Ximelagatran

Antikoagulan

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• LMWH

– Bemiparin, dalteparin, enoxaparin,

reviparin, fondaparinux

• Monitoring pemeriksaan darah

• Indikasi: trombosis vena, emboli paru,

PJR, penyakit jantung iskemik

Antikoagulan

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Aspirin

Dipiridamol

Tiklopidin

Klopidogrel

Epoprostenol (PGI2)

Abciximab

Antitrombotik

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Fosfolipid membran

Asam arakidonat

Rangsang

Gangguan pada membran sel

Hidroperoksid

Leukotrien

Endoperoksid (PGG2/ PGH)

PGE2, PGF2, PGD2, PGI2 Tromboksan A2

Fosfolipase

SiklooksigenaseLipooksigenaseAspirin

• Indikasi: cegah trombosis pada

TIA/ stroke, infark miokard, bedah

kardiovaskuler, Raynaud’s phenomen

Antitrombotik

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• Streptokinase

• Urokinase

• Plasminogen activator

(u-PA, t-PA)

Trombolitik

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• Indikasi: infark, emboli paru, trombosis

vena/ arteri

• Mahal

Trombolitik

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• Transfusi

• Faktor VIII

• Kompleks faktor II, V, IX, X

• Fibrinogen

• Vitamin K

• Asam aminokaproat

• Asam traneksamat

• Karbazokrom

Hemostatik

Further Reading

• Katzung BG, Masters SB, Trevor AJ. Basic and

Clinical Pharmacology 11th Edition. McGraw-Hill,

2009.

• Goodman & Gilman’s Manual of Pharmacology and

Therapeutics. McGraw-Hill, 2008