anti coagulant

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Seminar on ANTICOAGULANT Under the guidence of mR. nilanjan ghosh

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COAGULATION: Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis (the cessation of blood loss from a damaged vessel), wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel. Disorders of coagulation can lead to an increased risk of bleeding (hemorrhage) or clotting (thrombosis). COAGULANTS: These are the substance which promote coagulation and are indicated the haemorrhagic state. ⃚ANTICOAGULANT: An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombotic disorders. Some chemical compounds are used in medical equipment, such as test tubes, blood transfusion bags, and renal dialysis equipment.

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CLASSIFICATION OF ANTICOAGULANTS: ***Used in vivo A. Parenteral anticoagulants Heparin B. Oral anticoagulants  1. Coumarin derivatives: bishydroxycoumarin,Acenocoumarol. 2.Indandione derivative: Phenindione ***Used in vitro A. Heparin: 150 U to prevent clotting of 100 ml blood. B. Calcium complexing agent : Sodium citrate

WARFARIN MECHANISM ACTION : Warfarin acts as an anticoagulant by blocking the ability of Vitamin K to carboxylate the Vitamin K dependent clotting factors, thereby reducing their coagulant activity. : 

WARFARIN MECHANISM ACTION : Warfarin acts as an anticoagulant by blocking the ability of Vitamin K to carboxylate the Vitamin K dependent clotting factors, thereby reducing their coagulant activity.

Factors Affecting Warfarin Effect: : 

Factors Affecting Warfarin Effect: Drug Interactions Hereditary Resitance and Hypersenstivity cytochrome P450 (CYP2C9 mutn) Altered liver function Hypermetabolic state (fever, thryoid) Co-morbid conditions (chemotherapy, albumin)

Warfarin: Adverse Effects : 

Warfarin: Adverse Effects Fatal or non-fatal hemorrhage from any tissue or organ Necrosis of skin and other tissues Other adverse reactions reported less frequently include: cholesterol microembolization Alopecia Purple toes syndrome, urticaria, dermatitis including bullous eruptions

Heparin : 

Heparin Natural anticoagulant Binds to AT III Inactivates factors IIa, Xa, IXa, XIIa. Binds to platelets Inhibits plt function (contributes to bleeding) Heterogenous Mw 3,000 –30,000 ( 15,000 d)

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Heparin Mechanism of Action Accelerates antithrombin III activity Prothrombin Thrombin Factor Xa Factor Va Factor X Factor IXa Factor VIIIa Ca2+, PL Ca2+, PL Antithrombin III (Heparin)

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Low molecular weight heparins: Preferential inactivation of factor Xa Prothrombin Thrombin Factor Xa Factor Va Factor X Factor IXa Factor VIIIa Ca2+, PL Ca2+, PL Antithrombin III (LMWH)

Heparin Side Effects: : 

Heparin Side Effects: Bleeding Osteoporosis (inhibits osteoblasts, activates osteoclasts) > 3 mths, > 20,000 units qd Thrombocytopenia Type I HIT Type II HIT (3-5%) Skins lesions- urticaria, papules, necrosis Hypoaldosteronism, hyperkalemia

Heparin/LMWH—Adverse Effects : 

LMWH Bleeding Thrombocytopenia Hypersensitivity Heparin/LMWH—Adverse Effects Heparin Bleeding Thrombocytopenia Osteoporosis Hypersensitivity

USES OF ANTICOAGULANTS: : 

USES OF ANTICOAGULANTS: Deep vain thrombosis and pulmonary embolism. Myocardial infarction Unstable angina Rheumatic heart disease{Artrial fibfrilation} Cerebrovascular disease Vascular sergery Haemodyalysis Defibrination syndrome

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THANK YOU

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