Blood drugs

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IQRA RUBAB
• • Hemostasis: is a process which causes bleeding to
stop, meaning to keep blood within a damaged
blood vessel (the opposite of hemostasis is
hemorrhage)
• Clotting disorders :It is a term used to describe a
group of conditions in which there is an increased
tendency, often repeated and over an extended
period of time, for excessive clotting.
Thrombophilia:
known as hypercoagibility. It affects a large number
of people around the world. It affects approximately
5% to 7% of the European population.
Blood coagulation

• Blood coagulation
• 1) Intrinsic pathway all factors needed for Blood
coagulation are in plasma. Slow process as lot many
factors are needed to be activated.
• 2)Extrinsic pathway: also needs tissue factor-
thromboplastin. Occurs with in seconds.
•Blood drugs that are useful in treating three important
dysfunctions of blood:
1:Thrombosis.
2:Bleeding.
3:Anemia.

• formation of an unwanted clot within a blood vessels is

the most common abnormality of hemostasis.
• These are treated with drugs such as anticoagulants
and fibrinolytic.
Mechanism
• 1)Vaso Constriction. Within about 30 minutes of
damage/trauma to the blood vessels, vascular spasm
ensues, which leads to vasoconstriction. At the site of the
disrupted endothelial lining, the extracellular matrix (ECM)/
collagen becomes exposed to the blood components.
• 2)Platelet Adhesion. This ECM releases cytokines and
inflammatory markers that lead to adhesion of the platelets
and their aggregation at that site which leads to the
formation of a platelet plug and sealing of the defect. The
platelet adhesion is a complex process mediated by
interactions between various receptors and proteins
including tyrosine kinase receptors, glycoprotein receptors.
• 3)Platelet Activation. The platelets that have
adhered undergo very specific changes. They
release their cytoplasmic granules that include ADP,
thromboxane A2, serotonin, and multiple other
activation factors. They also undergo a
transformation of their shape into a pseudopodal
shape which in-turn leads to release reactions of
various chemokines. P2Y1 receptors help in the
conformational changes in platelets.
• 4)Platelet Aggregation. With the mechanisms
mentioned above, various platelets are activated,
adhered to each other and the damaged
endothelial surface leading to the formation of a
primary platelet plug.
• 5)Fibrin Clot Formation: The final steps in the
coagulation cascade involve the conversion of
fibrinogen to fibrin monomers which polymerizes
and forms fibrin polymer mesh and result in a cross-
linked fibrin clot. This reaction is catalyzed by
activated factor XIII (factor XIIIa) that stimulates the
lysine and the glutamic acid side chains causing
cross-linking of the fibrin molecules and formation of
a stabilized clot
• 6)Clot Resolution (Tertiary Hemostasis). Activated
platelets contract their internal actin and myosin
fibrils in their cytoskeleton, which leads to
shrinkage of the clot volume. Plasminogen then
activates to plasmin, which promotes lysis of the
fibrin clot; this restores the flow of blood in the
damaged/obstructed blood vessels.
Aspirin
Aspirin causes several different effects in the body,
mainly the reduction of inflammation, analgesia
(relief of pain), the prevention of clotting, and the
reduction of fever. Aspirin's ability to suppress the
production of prostaglandins and thromboxanes is
due to its irreversible inactivation of the
cyclooxygenase (COX) enzyme. Cyclooxygenase is
required for prostaglandin and thromboxane
synthesis.
Ticlopidine (TICLID) Clopidogrel (PLAVIX)
• Blocks platelet ADP • Similar to ticlopidine
receptor and prevents and used same way
activation and Less incidence of
aggregation Is often used neutropenia or
in combination with thrombocytopenia
aspirin (synergistic
action), for angioplasty Used in combination
and stenting surgery. To with aspirin.
prevent secondary strokes
and in unstable angina
Anticoagulants Heparin

• Heparin is used to treat and prevent blood clots in

the veins, arteries, or lung. It is also used before
surgery to reduce the risk of blood clots.
• Administration - parenteral- Do not inject IM - only
IV
• Adverse effect: hemorrhage
Fibrinolytics
• Thrombolytic drugs are used to dissolve (lyse)
blood clots (thrombi).
• 1:Streptokinase: Binds to plasminogen and
generate plasmin
• 2:They are used in acute myocardial infarction,
arterial and venous thrombosis, and pulmonary
embolism. These compounds are antigenic because
they are derived from streptococci bacteria.
Warfarin
• Warfarin is used to treat or prevent blood clots in
veins or arteries, which can reduce the risk of
stroke, heart attack, or other serious conditions.
• Side Effects:Severe bleeding, Bleeding from the
rectum or black stool, Skin conditions such as hives,
a rash or itching,Swelling of the face, throat,
mouth, legs, feet or hands, Bruising that comes
about without an injury you remember, Chest pain
or pressure Nausea or vomiting, Fever or flu-like
symptoms, Joint or muscle aches, diarrhea
Difficulty moving, Numbness of tingling in any part
of your body, Painful erection lasting four hours or