Chapter 2 - Bleeding Disorders Flashcards
What is the MoA of antifibrinolytics?
Inhibit fibrinolysis to promote blood clotting
What are two examples of antifibrinolytics?
Tranexamic acid
Desmopressin
What is an example of a haemostatic?
Emicizumab, which is a biologic (should be prescribed by the brand name)
What are the indications and doses of tranexamic acid?
Menorrhagia
1g TDS, initiated once menstruation has started
Local fibrinolysis
1-1.5g BD-TDS (mouth)
0.5-1g BD-TDS (slow IV injection)
Prevention and treatment of significant haemorrhage following trauma
1g over 10min (IV)
Then 1g over 8 hours (IV)
What are the main cautions/contraindications of tranexamic acid?
Contraindication - history of seizures
Caution - use of oral contraceptives
What are the main side effects of tranexamic acid?
Diarrhoea (reduce dose) Nausea Vomiting Colour vision changes (discontinue) Seizures (discontinue)
Can tranexamic acid be used in pregnancy?
Avoid unless benefit outweighs risk
When is dried prothrombin complex indicated?
Treatment of haemorrhage in congenital deficiencies of coagulation factors
Major bleeding in patients on warfarin following phytomenadione
What are the side effects of dried prothrombin complex?
Embolism, thrombosis, haemorrhage
Hypertension
Hepatic disorders
What is subarachnoid haemorrhage?
A type of stroke where there is bleeding into the subarachnoid space
What are the symptoms of a subarachnoid haemorrhage?
Sudden, severe headache
Not precipitated by exercise or sexual activity
What is the treatment for a subarachnoid haemorrhage?
Nimodipine
What class of drug is nimodipine?
CCB (dihydropyridine)
What are the contraindications of nimodipine?
Unstable angina
MI in the past month
What are 8 side effects of CCBs
Abdominal pain, nausea, vomiting Dizziness, drowsiness, headache Palpitations, tachycardia Peripheral oedema, angiodema Skin reactions Myalgia Erectile dysfunction Gingival hyperplasia Depression Thrombocytopenia Bradycardia
