Drugs Used to Control Bleeding

8/4/2019 Drugs Used to Control Bleeding..

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VARIOUS BLEEDING DISORDERS

Hemophilia

Liver disease

Bone marrow disorders


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ANTIHEMOPHILIC DISORDERS

Drug used to treat hemophilia are

replacement factors for the specific

clotting factors that are genetically

missing in the particular type ofhemophilia

These drugs include:

Antihemophilic factors (Bioclate, ReFacto, and

others)

Coagujlation factor VIIa (NovoSeven)

Factor IX complex (Benefix, Profilnine SD, and

others)


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THERAPEUTICACTIONS AND INDICATIONS

Antihemophilic drugs replace clotting

factors that are either genetically missing

or low in a particular type of hemophilia

They are used to prevent blood loss from

injury or surgery and to treat bleeding

episodes


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PHARMACOKENITICS

Agents replace normal clotting

factors and are processed as such by

the body.Should used during pregnancy only

if the benefit to the mother clearly

outweighs the potential risk to the

fetus.


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CONTRAINDICATIONS AND CAUTIONS

It is contraindicated in the presence of

known allergy to mouse proteins.

Factor XI is contraindicated in the

presence of liver disease w/ signs ofintravascular coagulation or fibrinolysis.

Coagulation factor VIIa is contraindicated

w/ known allergies to mouse, hamster, or

bovine products


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ADVERSE EFFECTS

Most common adverse effect associated w/

antihemophilic agents involve risk

associated w/ the use of blood products

Headache

Flushing chills

Fever and

Lethargy may occur as a reaction to theinjection of a foreign protein

Nausea and vomiting may also occur


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SYSTEMIC HEMOSTATICAGENTS

Hemostatisc drugs are used to stop

bleeding

These drugs that are used systematically

include the following:

Aprotinin (Tracylol)

Aminocarporoic Acid (Amicar)


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THERAPEUTICACTIONS AND INDICATIONS

The systemic hemostatic agents stop the

natural plasminogen clot-dissolving

mechanism by blocking its activation or

by directly inhibiting plasminThese drugs are used to prevent or treat

excess bleeding in hyperfibrinolytic states,

including repeat CABG surgery


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PHARMACOKINETICS

Pharmacokinetic parameters are different

for each drug


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CONTRAINDICATIONS AND CAUTIONS

Systemic hemostatic agents are

contraindicated in the presence of allergy

to these drugs and w/ acute DIC because

of the risk of tissue necrosis.Caution should be used in the in the

following conditions:

Cadiac disease

Renal and hepatic dysfunction

And Pregnancy and Lactation


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ADVERSE EFFECT

Most common adverse effect associated w/

systemic hemostatic agents is excessive

clotting.

CNS effects hallucinations, drowsiness,dizziness, headache, and psycotic states

GI effects nausea, cramps, and diarrhea

Aprotinin has been associated w/ cardiacarrythmias, MI, CHF, and hypotension


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CLINICALLYIMPORTANT DRUG-DRUG

INTERACTIONS

The risk o bleeding increase if these drugs

are given w/ heparin

Aminocaprioc acid is associated w/ the

development of hypercoagulation states ifit is combined w/ oral contraceptives or

estroggens


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TOPICAL HEMOSTATICAGENTS

Some surface injuries involve so much

damage to the small vessels in the area

that clotting does not occur and blood is

slowly and continually lostFor these situations, topical or local

hemostatic agents are often used:

Absorbable gelatin (Gelfoam)

Thrombin (Thrombinar, Thrombostat)


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END OF PRESENTATION!

Thank you!

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Drugs Used to Control Bleeding