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!