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ANTICOAGULANTS AND COAGULANTS CONTRAINDICATIONS

IMPORTANCE OF BLOOD CLOT  SBE


 Ulcerative Lesion
 Act as a seal that prevents further loss of blood,  Threatened Abortion
oxygen and nutrients from the wound site  Active Bleeding Tendencies
 Factors present in the clot promotes wound healing  Recent Brain Surgery
by signaling phagocytes to carry OFF waste products
and dead cells that accumulate at the site of injury HEPARIN

 Inhibits the function of the performed clotting


PLATELETS (Thrombocytes) Clotting Factors
factors
 Responsible for initiating coagulation
 Inhibits thrombin activity so that fibrin cannot be
(normal blood clot formation)
formed
WHAT HAPPENS DURING INJURY?  Inhibits thromboplastin activity so that more
thrombin cannot be generated
First Stage
 Interferes with platelet aggregation
1. Platelets migrate to damage area
Route of Administration
2. Platelets stick to each other (aggregation) or
platelets adhere to the vessel wall (adhesion)  Cannot be given orally because it destroyed by
3. Platelets form a plug around the injured tissue gastric acid
 Administered IV and SubQ
Second Stage
 IM should be avoided because painful hematomas
1. Clotting factors reach the platelet plug and interacts may occur
with each other to form a stable blood clot  Rapid onset of action, within 5mins
 With 2-4hrs duration of action
COAGULATION AND CLOT RESOLUTION PROCESS
 Metabolized in the liver and Excreted unchanged
Stage 1 into the uterine

“Thromboplastin substance is produced and once Side Effects


produced clotting proceeds automatically”
 Hemorrhage
Stage 2  At high level causes bleeding in the mucous
membrane (petechiae) and open wounds
“Thromboplastin converts prothrombin to
 Other side effects observed: hypersensitivity,
thrombin”
alopecia, osteoporosis, thrombocytopenia
Stage 3  Protamine sulfate
 Specific antidote in heparin toxicity
“Thrombin converts fibrinogen to fibrin (primary  Binds to heparin molecules and inhibits the
element of a blood clot)” anticoagulant action of heparin
Stage 4 COUMARIN DERIVATIVES
“Fibrinolysis acts upon the FIBRIN element to  ORAL ANTICOAGULANTS
produce a more stable product”
 Eg DICUMAROL and WARFARIN SODIUM
“Body’s ability to dissolve clot once their function  Slow onset of action at 12-72hrs
has ended”  With duration of action of 2-10 days
 Side effect is hemorrhage
HEPARIN AND COUMARIN DERIVATIVES  Other side effect : hematuria, bleeding of gums,
 Most frequent used ANTICOAGULANTS petechiae
 Prevents venous thrombosis, MI,  Antidote: 2.5 – 25 mg of vitamin K1(phytonadine)
Thrombophlebitis(inflammation of the wall of the parenterally IM SC but not IV because severe
veins), prevents stroke, and also used for clot anaphylactic type of reaction can occur.
suppression prior to blood transfusion and open GOODLUCK AND GODBLESS!!
heart surgery
LABAN DMD 

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