clotting and blood drugs

Question 1

heparin

method of action:

uses:

Answer 1

method of action: activates antithrombin 3 which inactivates clotting factor 2 & 10 - fibrin clot is unable to form

uses: anticoagulant

Question 2

warfarin

method of action:

uses:

dental relevance:

Answer 2

method of action: inhibits factors 2,7,9,10 & is a vitamin K antagonist so prevents activation of intrinsic and extrinsic clotting factors - prevents clotting cascade from occuring

uses: anticoagulant

dental relevance :

• increased risk of bleeding - invasive treatment: extractions or RPD
• to lower incidence of severe bleeding
  
  • use anaethetic with vasoconstrictor
  • use articaine rather than block when infiltration
  • aspirate
  • haemostatic socket packing such as surgicel
  • sutures to secure socket
• treat patient first in the morning at beginning of week - can deal with bleeding

Question 3

aspirin

method of action:

uses:

side effects:

Answer 3

Method of Action –

• Irreversibly blocks the cyclo-oxygenase 2 (COX 2) enzyme
  
  • which would otherwise convert arachidonic acid to prostaglandins (would lead to pain and inflammation) and thromboxane A2 (leads to platelet aggregation so clot formation)

Use –

• Atrial fibrillation, ischemic heart disease (on average 75mg OD), heart attack prevention and pain/inflammation relief (300-900mg, TDS or QDS)

Side Effect –

• Drug induced thrombocytopenia and in under 16’s Reye’s syndrome can occur (hepatic encephalopathy)

Question 4

clopridogrel

method of action:

uses:

side effects:

contraindications:

Answer 4

Method of Action – Prevents the ADP binding of platelets to each other so the platelet plug cannot form

Use – For people who cannot tolerate aspirin

Side Effect – Dizziness and Nausea

Contraindications: Active bleeding