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Thrombosis
- Formation of an unwanted clott inside a blood vessel
- Can lead to heart attack, stroke, pulmonary ambolism, deep vein thrombosis
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Bleeding Disorders
- Uncontrolled bleeding
- Usually genetic
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Anemia
Low RBC count, normal is 40-45%
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TXA2
- Stimulates activation of other platelets
- Facilitates platelet aggulation
- Causes local vasoconstriction
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Iron Products
- Treatment for anemia
- Ferrous Sulfate
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Folic Acid
- Treatment for Anemia
- Required for maintance and synthesis of RBC
- Results in large, immature and dysfunctional RBCs
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Cyanocobalamin Deficiency (B12)
- Indicates for pennicious anemia- lack of B12
- Treatment is B12 injections for life
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Erythropoetin
- Normally made in the kidney
- Epoetin Alpha and Darbepoetin are synthetic erythropoetins
- Indicated- anemias associated with renal failure
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Dipyridamole (Perantine)
- Platelet anhesion inhibitor
- MOA- increases TXA2, increases prosttacycin
- Agonist, MOA is unclear
- Used in combinaion with Coumadin to prevent thrombin formation on prostetic heart valve as it has no endotheleium
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Ticlopidine HCL and Clopidogrel (Plavix)
inhibit activation of platelets
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Abcixmab
- MOA- blocks the binding of Von Willibrand factor to receptor sites on platelets
- Given with heprin during surgical procedures to prevent platelet agregation
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Asprin
- MOA- inhibits TXA2 by the arachadonic acid pathway
- Prevents heart attack
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Heparin
- Naturally occuring molecule in the body produced by basophil and mast cells
- Injectable anticoagulant
- Interferes with formation of fibrin/fibrinogen
- Has effect on Anti-Thrombin III
- Can cause Heparin Induced Thrombocytopenia (HIT)
- Used in deep vein thrombosis, Pulmonary embalisn, and surgical procedures
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Low Moelcular Weight Heparin (LMWH)
- Increase ratio of anti-factor 10to anti-factor 2 activity
- Less effect on thrombin
- Used for deep vein thrombosis and pulmonary
- Long acting (24hrs)
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Direct Thrombin Antagonist
- Leperudin and Agatroban
- Prevent fibrin blood clotts
- indicated by direct thrombin disorders where heparin is too much
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Vitamin K Antagonist
- Warfarin
- MOA_ Inhibits synthesis of clotting factors 2,7,9,10 in the liver
- Prevents DVT and Pulmonary
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Thrombolytic Drugs
- Drugs used to dissolve blood clotts
- MOA- Activate conversaion plasminogen to plasmin which dissolves clotts
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Alteplase (Activase)
- MOA- Rapidly activates plasminogen that has bound to fibrin in clott
- Used in heart attack, pulmonary, and acute aschemic stroke
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Streptokinase (Streptase)
- MOA- Rapidly activates plasminogen that has bound to fibrin in clott
- Used in heart attack, pulmonary, and acute aschemic stroke
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Aminocaproic Acid (Amicar)
- MOA- Inhibites fibrinolysis by inhibiting conversion of plasminogen to plasmin
- Used in hemophilia and post surgery
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Protamine Sulfate
- Reverses effects of heparin
- Basic and combines with acidic heparin to form neutral salt
- Used post-surgery and to reverse heparin
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Vitamin K
Promotes Factors 2,7,9, and 10
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Aprotinin (Trasylol)
- Blocks plasmin
- Indicated by blood loss in surgery and post-operative bleeding
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Tranexamic (Cyclokapron)
- Inhibits plasmin
- Used in post-operative bleeding
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