Disorders of bleeding and thrombosis Disseminated intravascular coagulation

Disorders of bleeding and thrombosis Disseminated intravascular coagulation

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Disorders of bleeding and thrombosis Disseminated intravascular coagulation (DIC) Disseminated intravascular coagulation (DIC) This is a generalised activation of clotting and fibrinolytic systems and can be caused by abruptio placentae or amnionic fluid embolism in pregnant women. Certain bacterial infection and transfusion mismatch may also be a cause. To diagnose DIC look for low platelets (enmeshed in fibrin clots), prolonged APPT and PT (depleted clotting factors) and always remember to treat the cause. Do this with transfusion of blood, fresh-frozen plasma and platelets, heparin. Anticoagulant drugs Anticoagulant drugs HAPI WEPT Heparin, - APPT, Intrinsic pathway Warfarin - Extrinsic pathway, prothrombin time (PT) Heparin This works by potentiating the action of antithrombin III and inactivating activated serine
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Unformatted text preview: proteases. Heparin prolongs APPT but can cause serious side-effects such as; thrombocytopenia, osteoporosis, alopecia and hypersensitivity. If an overdose is given, stop heparin, give protamine sulphate if severe, though heparin has short half life anyway. Warfarin This is a vitamin K antagonist and inhibits production / activation of vitamin K-dependant factors (II, VII, IX and X). Warfarin Prolongs PT (and INR) but has many drug interactions: • Decrease intestinal absorption of vitamin K (antibiotics, laxatives) • Reduce warfarin binding to albumin (phenylbutazone) • Inhibit hepatic degradation (cimetidine) • Side-effects: Teratogenic. • Overdose / over anticoagulation:Stop warfarin, give fresh-frozen plasma and / or vitamin K...
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This note was uploaded on 12/04/2011 for the course ANTHRO 2000 taught by Professor Monicaoyola during the Fall '10 term at Broward College.

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Disorders of bleeding and thrombosis Disseminated intravascular coagulation

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