PPT_Chapter_48_updated - Drugs Affecting Blood Coagulation Chapter 48 Copyright 2013 Wolters Kluwer Health | Lippincott Williams Wilkins Blood Vessel

PPT_Chapter_48_updated - Drugs Affecting Blood Coagulation...

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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Drugs Affecting Blood Coagulation Chapter 48
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Blood Vessel Injury • Local vasoconstriction seals off small injury • Platelet aggregation forms a platelet plug • Hageman factor is activated (factor XII) • Intrinsic pathway converts prothrombin to thrombin to seal system • Extrinsic pathway clots the blood that has leaked out of the vascular system
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Process of Blood Coagulation
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Damaged Vessel Endothelium is a Stimulus to Platelets, Causing Platelet Adhesion
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Blood Disorders • Thromboembolic Disorder – Conditions that predispose a person to the formation of clots and emboli • Hemorrhagic Disorder – Disorder in which excess bleeding occurs
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question How do antiplatelet medications work? A. Interfere with the clotting cascade B. Alter the formation of the platelet plug C. Stimulates the plasmin system D. Initiates the clotting cascade
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Alter the formation of the platelet plug Rationale: Antiplatelets alter the formation of the platelet plug.
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Actions of Anticoagulants • Anticoagulants – Interfere with the clotting cascade and thrombin formation • Antiplatelets – Alter the formation of the platelet plug • Thrombolytic Drugs – Break down the thrombus that has been formed by stimulating the plasmin system
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Antiplatelet • Abciximab (ReoPro) • Anagrelide (Agrylin) • Aspirin • Cilostazol (Pletal) • Clopidogrel (Plavix) • Dipyridamole (Persantine) • Eptifibatide (Integrilin) • Ticlopidine (Ticlid) • Ticagrelor (Brilinta) • Tirofiban (Aggrastat)
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Antiplatelet (cont.) • Actions – Inhibit platelet adhesion and aggregation by blocking receptors sites on the platelet membrane – Anagrelide – Blocks the production of platelets in the bone marrow • Indications – Reduce risk of recurrent TIAs or strokes; reduce death or nonfatal MI; MI prophylaxis; anti-inflammatory, analgesic, and antipyretic effects • Pharmacokinetics – Well absorbed and bound to plasma proteins – Metabolized in the liver and excreted in the urine
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Antiplatelet (cont.) • Contraindications – Allergy, pregnancy, and lactation • Caution – Bleeding disorder, recent surgery, closed-head injury • Adverse Effects – Bleeding – Headache, dizziness, and weakness – GI distress • Drug-to-Drug Interactions – Another drug that affects blood clotting
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Prototype Antiplatelets
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