Anticoagulants and Vitamin K
Terms
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- heparin
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- parenteral anticoagulant
- catalyzes inactivation of clotting factors by antithrombin III
- used in low doses post-op - warfarin
-
- oral anticoagulant
- delayed action since it prevents synthesis of clotting factors
- antagonizes vitamin K - drug interactions in clotting
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- phenylbutazone displaces warfarin from plasma proteins
- barbiturates stimulate metabolic inactivation of anticoagulants
- antibiotics decrease available vitamin K, increasing the effectiveness of anticoagulants
- large vitamin K doses overcome the inhibition - vitamin K
- - induces the post-translational carboxylation of factors 2, 7, 9, 10, proteins C and S, prothrombin and maybe tissue factor
- class 1 of platelet aggregation inhibitors
- - aspirin, indomethacin, sulfinpyrazone inhibit cyclo-oxygenase and block TXA2 formation
- dipyrimadole
- - platelet inhibitor which increases intracellular levels of inhibitory messenger cAMP
- clopidogrel and ticlopidine
- reduce platelet aggregation by inhibiting the ADP pathway of platelet aggregation
- abciximab, eptifibatide, tirofiban
- glycoprotein IIb/IIIa inhibitors; block the final common pathway for platelet aggregation
- streptokinase and urokinase
- cause systemic plasmin formation, which degrades numerous circulating proteins like fibrinogen and coagulation factors
- t-PA (tissue plasminogen activators)
- bind tightly to fibrin and restricts its activity to vicinity of the thrombus