Anticoauglants

1. Antithrombotic,thrombolytic,and Anticoagulants
COAGULATION CASCADE

3. Drug Duration(Half
Antigenicity Specifity
characteristics life) in minutes
Streptokinase YES NO About 30
Urokinase NO NO About 20
Altaplase NO YES About 10

4. CLINICAL USES OF FIBRINOLYTIC DRUGS
IN THE FOLLOWING EMERGENCE CASES:
1) STROKE.
2) Multiple Pulmonary thromboembolism.
3) myocardial infarction.
***** BODY FACTORS THAT: *****
1) Increase The Effect Of Warfarin:
a) Hepatic Diseases. b) Hypothyroidism
2) Decrease The Effect Of Warfarin:
a) Hereditary Resistance b) Hyperthyroidism

5. CLASSIFICATION OF ANTICOAGULANTS
A) IN VITRO:
1- HEPARIN
2-Ca- COMPLEX AGENTS: a) Na-Citrate
b) Na-Oxalate
C)Na-Edetate
B) IN VIVO:
1- HEPARIN , LMWs ( e.g. enoxaparin,deltaparin )
and Heparinoides (e.g.Danaparoid and Lepirudin)
2-ORAL ANTICOAGULANTS:

6. MECHANISM OF ACTION OF HEPARIN

8. Drug Major Setting Interaven- Anticoa- Bio-
characteri- Adverse for ous gulant avail-
stics effect therapy Half-life response ability
Frequent
Heparin Hospital Two hours Variable 20%
Bleeding
low
Hospital
molecular Less Predict-
and out- Four hours 90%
weight Bleeding able
patient
heparin

10. CLINICAL USES OF HEPARIN
1) Deep vein thrombosis.
2) Pulmonary thromboembolism.
3) myocardial infarction.
4)Before and after thorax , orthopedic surgery.
5) Unstable angina.
6) In extracorporeal Circulation.

11. A) ADVERSE REACTIONS(side-and toxic effects):
1) Hypersensitivity reactions.
2) Hemorrhage.
3)Thrombocytopenia.
4) Alopecia. 5)Osteoporosis ( prolonged use of heparin ).
B)CONTRAINDICATIONS :
1)Heparin Hypersensitivity.
2) Patients with active bleeding or
bleeding tendencies.

12. DRUG DRUG – INTERACTIONS OF WARFARIN
1)Increase the effect of warfarin:
a) Use of metronidazol or erythromcin or cimetidine.
b) Use of aspirin or sulfonamide or indomethacin.
c) Use of oral broad spectrum antimicrobials:
ampicillin or tetracycline.
d) use of antithrombotic drugs : clopediogrel or
teclopedin or aspirin.
e) Use of liquid paraffin.
2) Decrease the effect of warfarin:
a) Use of inducers : phenobarbitures or rifampin.
b) Use of vitamin K.
c) Use of cholestyramine.
d) Use of oral contraceptives.

13. MECHANISM OF ACTION OF VIT.K