Presentation on theme: "Drugs for Coagulation Disorders"— Presentation transcript:
1 Drugs for Coagulation Disorders 20Drugs for Coagulation Disorders
2 Learning Outcomes Explain the importance of hemostasis. Construct a flow chart diagramming the important steps of hemostasis and fibrinolysis.Describe the types of disorders for which coagulation modifier drugs are prescribed.Identify the primary mechanisms by which coagulation modifier drugs act.
3 Learning OutcomesFor each of the classes in the Drug Snapshot, identify representative drugs, explain their mechanisms of action, primary actions, and important adverse effects.Categorize coagulation modifier drugs based on their classifications and mechanisms of action.
4 Core Concept 20.1Hemostasis is a complex process involving multiple steps and many clotting factors. Hemostasis is the balance between clot formation and clot breakdown
5 CoagulationEveryone is familiar with simple cuts and scraps and we all take for granted that they will stop bleeding in a few minutes.
12 ClotsOnce a stationary clot forms (thrombus), it often grows larger as more fibrin is added.Pieces of the clot may break off and travel in the blood stream to possibly lodge elsewhere.A traveling clot is know as an embolusWhen clots or emboli form, drug therapy becomes necessary.
14 Drugs are used to modify the coagulation process. Core Concept 20.3Drugs are used to modify the coagulation process.
15 Drugs Anticoagulants used to prevent the formation of clots Inhibit specific clotting factors in the coagulation cascade or diminish the clotting action of plateletsIncrease the normal time the body takes to form clots
16 “Blood Thinners” This is an incorrect term; However, it is commonly used.The drugs do not change the thickness of the blood, just inhibits the clotting cascade
17 Drugs Thrombolytics used to dissolve such life-threatening clots. Hemostatics used to speed clot formation, or to limit bleeding from a surgical site.
18 Anticoagulants prevent the formation and enlargement of clots. Core Concept 20.4Anticoagulants prevent the formation and enlargement of clots.
19 Anticoagulants Actions Adverse effect is bleeding. Inhibit certain clotting factorsLengthen clotting timePrevent thrombi from forming or growing largerAdverse effect is bleeding.Specific blockers administered to reverse the anticoagulant effects
20 Primary Anticoagulants heparin (Hep-Lockwarfarin (Coumadin)Coumadin therapy can overlap heparin therapyDo not give ASA with these drugsRANDI Precautions
22 Antidotes: Anticoagulants Protamine sulfate is used for heparin Vitamin K is administered for warfarin.
23 Vitamin KFoods high in Vitamin K can reverse the action of warfarin (Coumadin)Green leafy vegetablesMilk and milk productsSome cerealsOrange juiceCauliflowerCucumbers
24 Laboratory Tests Oral Anticoagulants Prothrombin time (PT)Normal range for PT is 12 to 15 secondsProlonged with anticoagulant treatment.International Normalized Ratio (INR)Method of performing PT tests varies from laboratory to laboratory
25 Laboratory Tests Oral Anticoagulants This is PT multiplied by a correction factor.Recommended post-treatment INR values range from 2 to 4.5.
30 Core Concept 20.5Antiplatelet agents prolong bleeding time by interfering with platelet aggregation.
31 Antiplatelet Agents Used to prevent clot formation in arteries. Three primary subclasses of antiplatelet agentsAspirinAdenosine diphosphate (ADP) receptor blockersGlycoprotein IIb/IIIa receptor blockers.
33 Thrombolytics are used to dissolve existing clots. Core Concept 20.6Thrombolytics are used to dissolve existing clots.
34 ThrombolyticsPrescribed for disorders in which a clot has already formed, including the following:Acute MIPulmonary embolismCerebrovascular accident (CVA)DVT
35 ThrombolyticsPrescribed for disorders in which a clot has already formed, including the following:Arterial thrombosisCoronary thrombosisTo clear thrombi in arteriovenous cannulas and blocked IV catheters