coagulants in detail with all drugs, mechanism of action, advantages, adverse effect, contraindication with example and pictures. in simplified manner , easy to understand

2.  Haemostasis & blood coagulation involve
complex interactions between the injured
vessel wall, platelets & coagulation factors
 For blood to clot, a cascading series of
proteolytic reactions is started by.
1. Contact activation of Hageman factor:
 intrinsic system.
 Slow and takes several minutes to activate
factor X.

3. 2. Tissue thromboplastin-
 extrinsic system.
 Needs a tissue factor.
 Activates factor x in seconds.
Clotting factors are present in the plasma in the
inactive form.
↓partial proteolysis.
Active protease ----→ activates next factor.
Antithrombin, protein C, protein S, antithromboplastin
and the fibrinolysin system ---- oppose coagulation
& lyse formed clot

6. These are agents which promote coagulation
and are indicated in the haemorrhagic
states.
Fresh whole blood/plasma provide all the
factors needed for coagulation.

7. Coagulants
Systemic agents
Vitamin k
K1 (phytonadiones)
K2 (menaquinone)
K3 (menadione)
Miscellaneous
Fibrinogen
Antihaemophilic factor
Desmopressin
Adrenochrome mono-
semmicarbozone
Ethamsylate
Rutin
Local agents
Astergents
Adrenaline
Thrombin
Fibrin
Gelatiin
Calcium alginate
Oxidized cellulose

8. 1. Vitamin K:
K1 [ from plants]-phytonadione.
K2 [ from bacteria]-Menaquinones
K3 [ synthetic] Fat soluble- Menadione,
-Acetomenaphthone
Water soluble- Menadione
sod.bisulfite
- Menadione
sod.diphosphate

9.  Fat soluble, required for the synthesis of
clotting factors.
 Daily requirements: it is uncertain, variable
amount becomes available from colonic
bacteria. 50-100μg/day
 Dietary sources: green leafy vegetables.
Liver, cheese etc.

10.  Action: acts as a cofactor at a late stage in
liver during synthesis of coagulation proteins-
II, VII, IX & X.

11.  Fat soluble forms
are absorbed from
intestine via lymph
and require bile
salts for
absorption.
 Stored mainly in
liver.
 Metabolites are
excreted in bile or
urine.

12.  liver disease,
 obstructive jaundice
 malabsorption,
 long term antimicrobial therapy

13. I. Dietary deficiency >5-10mg/day
oral/parenteral vit K
II. Prolonged antimicrobial therapy
III. Obstructive jaundice/malabsorption
syndromes >vit K 10mg/day i.m./orally
IV. Liver disease(cirrhosis, viral hepatitis)
V. Newborns>vit K 1mg i.m.
VI. Overdose of oral anticoagulants:K1.dose
depends on the severity of bleeding &
hypoprothrombinaemia
VII. Prolonged high dose salicylate therapy.

14.  Flushing,
 breathlessness,
 constriction in chest,
 fall in BP.
 Sweating
 Cyanosis, etc.

15. Fibrinogen- control bleeding in
haemophilia, Antihaemophilic globulin
(AHG) deficiency & acute fibrinogenemic
states

16.  concentrated human AHG prepared from
pooled human plasma.
 Used to control bleeding in haemophiliacs
 ADVERSE EFFECTS: fever with chills,
headache and skin rashes.

17. Ethamsylate:
It decreases capillary bleeding when
platelets are adequate; probably exerts
antihyaluronidase action & improves
capillary wall stability, but does not stabilize
fibrin.
It is used in capillary bleeding in
menorrhagia, after abortion, PPH, epistaxis,
haematuria, malena,after tooth extraction.
SE:nausea,rash,headache,fall in BP

18. Desmopressin:
 Releases factor VIII & von Willebrand’s
factor from vascular endothelium.
 Used to control bleeding in haemophilia and
von willebrands’s disease

19. Adrenochrome
monosemicarbazone:
Reduce capillary fragility,control oozing
from raw surfaces & prevent microvessel
bleeding.
e.g. epitaxis, haematuria,etc.

20. Rutin:
 Plant glycoside.
 reduce capillary bleeding
 Used along with vit C

21.  These are substances used to stop bleeding
from a local & approachable site. Effective
on oozing surfaces.
 E.g. bleeding following tooth extraction,
abrasion, epistaxis, etc.

22. 1. Thrombin- obtained from bovine
plasma. It is applied as dry powder
on the bleeding surface. Used in
haemophilia, neurosurgery, skin
grafting.

23. 2. Fibrin-obtained from human plasma and is
dried; it is used as sheets or foam for
covering or packing bleeding surfaces. It is
left in situ.

24. 3. Gelatin foam- spongy gelatin.
- Moistened with saline or thrombin solution
& used for packing wounds.
- Absorbed in 1-2 months. It is left inside.

25. 4. Russels viper venom- applied locally. Acts as
thromboplastin. Used to stop external
bleeding in haemophiliacs
5. Vasoconstrictors .-0.1% solution adrenaline
To stop epistaxis.
6. Astringent- tannic acid or metallic salts.
Bleeding gums,bleeding piles.