Heparin ( Unfractioned Heparin and Low molecular Heparin ) Tranexamic acid

1. Drugs affecting blood coagulation
Presented by
Naimat Afridi
PHR-120142032
To: Sir. Muhammad Imran Khan 1

2. Heparine
History
Discovered in 1916 by Mc Lean.
It was named Heparine because it was obtained from
liver.
In 1937 it was used for clinical purpose after
purification
Class
Anticoagulant
Forms of Heparin
 Unfractioned heparin ( UFH )
 Low molecular heparin (LMWH I,e Enoxaparine )
To: Sir. Muhammad Imran Khan 2

3. Coagulation Cascade
.
To: Sir. Muhammad Imran Khan 3

4. Mechanism
.
To: Sir. Muhammad Imran Khan
4

5. Mechanism of UFH
.
To: Sir. Muhammad Imran Khan
Unfractioned
heparin (UFH)
5

6. Mechanism of LMWH ( Enoxaparine )
To: Sir. Muhammad Imran Khan
LMH
(Enoxaparin)
6

7. Indications
ACS
Unstable Angina
DVT
Prophylaxis of thrombosis
To: Sir. Muhammad Imran Khan 7

8. Dosage form and Strength
Heparin
Injection
1000, 5000 & 20,000 IU inj. ( as sodium )
Dose
DVT, pulmonary embolism,
other intravascular coagulation
disorders
To: Sir. Muhammad Imran Khan
Initial 5000---10000
units
Maintanance 4000----5000
units
LMWH (Enoxaparin)
Injection 20mg , 40mg , 60mg , 80mg
8

9. Adverse effects
 HIT
 Haemorrhage
( Hematuria , GI bleeding
Gum bleeding )
 Osteoporosis
 Hypersensitivity Reactions
 Reversible Alopecia
To: Sir. Muhammad Imran Khan 9

10. Interactions
warfarin etc..
Cephalosporins
Thrombolytic agent
Aspirin
NSAIDs
To: Sir. Muhammad Imran Khan
Increase Toxicity
10

11. Heparin Vs LMW-H (
Enoxaparin )
 Low S/C bioavailibilty
( 20-30 % )
 Short half life
 Laboratory monitoring is
required
 Can be given in Renal
failuer
 Pregnancy class C
 High S/C bioavailibilty
( 70-90 % )
 Long half life
 Lab monitoring is not
required
 Cant be given in Renal
failuer
 Class B
To: Sir. Muhammad Imran Khan 11

12. Tranexamic acid ( TXA )
TXA is a synthetic derivative of amino acid Lysine belong to
class of Antifibrinolytic Agents
Mechanism
To: Sir. Muhammad Imran Khan
TPA ( Tissue plasminogen activator )
12

13. Dosage form and strength
 Capsule----------- 250mg
 Injection------------250mg
Indications
For prevention/control of excessive bleeding due
to:
 Fibrinolytic drugs.
 Cardio-pulmonary bypass surgery.
 tooth extraction in haemophiliacs.
 Menorrhagia, especially due to IUCD.
 Recurrent epistaxis
 trauma, peptic ulcer.
 Post partum Heamorrhage
To: Sir. Muhammad Imran Khan 13

14. Adverse effects
 Thromboembolic events ( DVT , PE
etc )
 Visual disturbances ( on prolong use )
 Seizures
Interactions
With
 Anticoagulants ( antagonistic effect )
 Mestranol ( increase toxicity )
To: Sir. Muhammad Imran Khan 14

15. .
To: Sir. Muhammad Imran Khan 15