Anesthesia Pharmacology Chapter 25:  Drugs that Affect Coagulation    Coagulation

 

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Drugs and Blood Coagulation

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Blood Coagulation: Mechanisms

Anticoagulant Drugs: Pharmacology

Fibrolytic Drugs

Antithrombotic Agents- Antiplatelet Drugs

Pharmacological Management of Thrombosis

 

Blood Coagulation: Mechanisms

Blood Coagulation Cascade: Proposed Model

 

 

Clotting Factors: Drug Target Sites

Factor/Component

also called

Target

I

Fibrinogen

 

II

Prothrombin

Heparin (IIa); Warfarin (synthesis)

III

Tissue Thromboplastin

 

IV

Calcium

 

V

Proaccelerin

 

VII

Proconvertin

Heparin (VIIa); Warfarin (synthesis)

VIII

Antihemophilic globulin (AHG)

 

IX

Christmas factor, plasma thromboplastin component (PTC)

Heparin (IXa); Warfarin (synthesis)

X

Stuart-Prower factor

Heparin (IXa); Warfarin (synthesis)

XI

Plasma thromboplastin antecedent (PTA)

 

XII

Hageman factor

 

XIII

Fibrin-stabilizing factor

 

Proteins C and S

-------

Warfarin (synthesis)

Plasminogen

-------

Thrombolytic enzymes, aminocaproic acid

 

Coagulation and Fibrinolysis: Regulation

Anticoagulant Drugs: Pharmacology

 

 

 

 

Fibrolytic Drugs

Antithrombotic -- Antiplatelet Drugs

 

 

Pharmacological Management of Thrombosis

 Drugs Used in Bleeding Disorders

Plasma Fractions-- Bleeding due to factor deficiencies

Fibrolytic Inhibitors:aminocaproic acid

 

 

Serine Protease Inhibitors: Aprotinin

 

Primary Reference: O'Reilly, R.A. Drugs Used in Disorders of Coagulation, in Basic and Clinical Pharmacology, (Katzung, B. G., ed) Appleton-Lange, 1998, pp 916-940
Handlin, R.I. Bleeding and Thrombosis, In Harrison's Principles of Internal Medicine 14th edition, (Isselbacher, K.J., Braunwald, E., Wilson, J.D., Martin, J.B., Fauci, A.S. and Kasper, D.L., eds) McGraw-Hill, Inc (Health Professions Division), 1998, pp 339-344.

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