coagulation disorders
Terms
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- Heparin
-
acidic (protamine)
parenterally
LMW Heparin - enoxaparin have greater bioavailability and longer duration. SC
Fondaparinux -
Heparin
mechanism of action - bind to AT3- the complex irreversibly bind and inactivate thrombin, F10...
-
LMW Heparin
mechanism of action -
have the same action on AT3 and F10 but not on thrombin.
PTT test is not relavent -
Heparin
clinical use -
rapid action- given when needed immediatly.
DVT
Pulmonary embolism
MI
(DOES NOT CROUS THE PLACENTA) -
Heparin
Toxicity -
increased bleeding
moderate transient thrombocytopenia
* some patients may develop antibodies against heparin bound to platelet factor 4 = severe thrombocytopenia and thrombosis.
prolong use- osteoporesis - Direct thrombin inhibitors
-
Lepirudin
Bivalirudin
Argatroban הרגה טרובן -
Direct thrombin inhibitors
mechanism of action -
Lepirudin and Bivalirudine- bind simultaneously to the active site of thrombin and to thrombin substrates.
Argatroban- bind only to the thrombin.
They inhibit both soluble and enmeshed thrombin. - Coumarin anticoagulantes
- Warfarin- small lipid soluble, orally administratef, cross the placenta. highly bound to albomin- eliminated by the cyt p450.
-
Coumarin anticoagulantes
mechanism of action - interfere with the posttranslational modification of clotting factors in the liver, a procedd that depends on vitamin K.
- ANTIPLATELETS
-
ASPIRIN
PDE3 INHIBITORS
ANTAGONISTS OF ADP RECEPTORS
GLYCOPROTEIN RECEPTOR INHIBITORS - ASPIRIN
- inhibits thromboxane synthesis by blocking the enzyme cyclooxygenase.
- ANTAGONISTS OF ADP RECEPTORS
-
ticlopidine
clopidogrel - PDE3 INHIBITORS
-
dipyridamole
cilostazol - GLYCOPROTEIN RECEPTOR INHIBITORS
- abciximab - monoclonal antibody that reversibly inhibits the binding of fibrin to the glycoprotein receptor.
-
ticlopidine
toxicity -
cause bleeding
TTP - THROMBOLITIC
-
alteplase
reteplase
tenecteplase
streptokinase
urokinase
anistreplase
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