Blood

Question 1

Anticoagulant

Answer 1

Drugs that reduce the coagulability of the blood

Question 2

Classification

Answer 2

In vivo parenteral oral
In vitro
-Heparin
-oxalates
-citrates
-sodium edetate

Question 3

Heparin

Answer 3

Power anticoagulant tht acts instantaneously both in vivo and in vitro

Question 4

Heparin MOA

Answer 4

★antithrombin 3 is a peptide tht is synthesized in the liver and circulates jn the plasma
★binds and activates plasma antithrombin 3
★antithrombin 3 bind to and inhibits activated thrombin and coagulation factors (Xa&IXb)
★this is a normal physiological reaction but heparin accelerates it 1000 times
★heparin inbits both activated factor X and thrombin but LMW only inhibits factor X

Question 5

Heparin pk

Answer 5

★It is not effective orally . It is given iv or sc ,it should not be given IM because it may cause hematomas at the site of injection due to local bleeding
★Treatment is monitored by aptt or clotting time
★because of its large molecular size heparine does not cross placental barrier therefore heparin can be used during pregnancy,if anyicoagulan is needed

Question 6

Heparin A/E

Answer 6

1.Bleeding
2.hypersensitivity(because of its animal origin,allergic reactions are quite common)
3.heparin induced thrombocytopenia-heparin induced platelet aggregation and formation of antiplatelet antibodies -both result in thrombocytopenia and systemic hypercoagulable state
4.Alopeciareversible in 0.5%patient
5.osteoporoses
6.hypo aldosteronism may inhibitut synthesis of aldosteron and may result in hyperkalemia

Question 7

LMW

Answer 7

★It includes enoxaprin,dalteprarin,reviparin,nadreparin
★ lmw heparins are obtained by chemical or enzymathc treatment of standard heparin
★LMW heparins have favourable pk profile
★they have shorter chains and lower molecular weight
★since LMW heparins inhhvmbit factor Xa only and have just a weak effect on thrombin ,aptt or clotting time are not prolonged

Question 8

LMW adv

Answer 8

1.Better bioavailability following sc injection
2.Longer action once or twice daily administration
3.predictabke pk and plasma levels frequent aptt monitoring not required
4.lower risk of bleeding
5.lowe risk of osteoporosis
6.lowerincidence of thrombocytopenia and theombosis

Question 9

LMW uses

Answer 9

1.prevention and treatment of vein thrombosis and pulmonary embolism
2.to maintain the patency of tube in dialysis patients

Question 10

Parenteral iron preperation

Answer 10

Intramuscular injection is given deep IM into the gluteal region using Z technique to avoid staining of the skin

IRON DEXTRAN
It has 50 mg elemental iron ut is the only preperation that can be given intravenously it can also be given as deep IM

Iron dextran is stable complex if ferric iron and dextran polymers