Protein binding p450 aspirin note that ibuprofen

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Unformatted text preview: lating more cancerous growth has not been ruled out. • G-CSF = granulocyte colony stimulating factor filgrastim (Neupogen®) • GM-CSF = granulocyte and monocyte colony stimulating factor - sargramostin (Leukine®) • Thrombopoietin - a megakaryocyte stimulating factor - not yet in clinical trials Drugs Affecting Blood Coagulation Drugs • Hemostatics – hasten blood clotting • Anticoagulants – retard blood clotting • Thrombolytics – – dissolve clots that have already formed. • Hemostatics - hasten blood clotting – Mechanism of Action • Mechanical coagulants (for use during surgery) i.e. Gelfoam or oxidized cellulose - cause platelets to disintegrate • actual clotting factors - i.e. thrombin (topical application) or platelets (transfusions) • Vitamin K - essential to prothrombin synthesis by liver • Anticoagulants - retard blood clotting – – – – – Heparin Coumarin Derivatives – Pl.Protein Binding – P450 Aspirin Note that ibuprofen (Advil Dipyridamole And Esp. COX-2 inhibitors are Pentoxifylline NOT to be substituted for aspirin. Anticoagulants Anticoagulants • Therapeutic Uses – venous thrombosis (prevention or treatment) • preventative if circulation sluggish, i.e. bed rest, myocardial infarction, polycythemia – prevention coronary thrombosis - especially if atherosclerosis present – atrial fibrillation or valve disease where blood not emptied from heart • Side or Toxic Effects – hemorrhage - clotting time should be closely monitored – bleeding may occur from G.I. tract, gums, nose, uterus, etc. – 25% of deaths from G.I. bleeding Anticoagulants Anticoagulants • Cautions or Contraindications – – – – – patients with bleeding tendencies ulcers or carcinomas of G.I. tract pregnancy - risk of abortion severe liver or kidney disease avoid IM injections -- muscle too vascular and may cause hematoma *Patients should carry MEDALERT in case of emergency – drug interactions can be very serious • phenobarbital - incr. deactivation by liver - need more anticoagulant to prevent thrombosis • phenylbutazone (treats gout) - displaces anticoagulant from plasma protein – (97%...
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