This document discusses treatments for bleeding and anticoagulation. It begins by defining anticoagulants as drugs that prevent blood clotting and notes they can be used as medications. It then discusses different types of anticoagulant medications including new oral anticoagulants and coumarins. Coumarins like warfarin are derived from plants and take 2-3 days to take effect. The document also notes the risks of coumarin therapy and lists some available agents. It concludes with an overview of symptoms common to many types of anemia such as fatigue, pallor, and shortness of breath.

1. BLEEDING &
ANTICOAGULATION
TREATMENTS AND MEDICATIONS

2. BLEEDING &
ANTICOAGULATION
TERMINOLOGY AND
DEFINITIONS

3. TREATMENTS FOR BLEEDING
 Anticoagulants (antithrombics, fibrinolytic, and thrombolytics) are a class of drugs that work to
prevent the coagulation (clotting) of blood. Such substances occur naturally in leeches and blood-
sucking insects.
 A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for
thrombotic disorders. Some anticoagulants are used in medical equipment, such as test tubes,
blood transfusion bags, and renal dialysis equipment.

4. TREATMENTS FOR BLEEDING
Medications
 Anticoagulants reduce blood clotting which can help prevent deep vein thrombosis, pulmonary
embolism, myocardial infarction and ischemic stroke.
 The new oral anticoagulants (NOACs) including dabigatran, rivaroxaban, and apixaban have been
shown to be as good or better than the coumarins (vitamin K antagonists) with less serious side effects.

5. TREATMENTS FOR BLEEDING
Coumarins (vitamin K antagonists):
 These oral anticoagulants are derived from coumarin, which is
found in many plants. A prominent member of this class is warfarin
(Coumadin). It takes at least 48 to 72 hours for the anticoagulant
effect to develop. Where an immediate effect is required, heparin
must be given concomitantly.
 These anticoagulants are used to treat patients with deep-vein
thrombosis (DVT), pulmonary embolism (PE) and to prevent emboli
in patients with atrial fibrillation (AF), and mechanical prosthetic
heart valves.
Figure showing process of O2 binding to hemoglobin
molecules

6. HEMATOPOIESIS
Adverse effects
 Patients aged 80 years or more may be especially susceptible to bleeding complications, with a
rate of 13 bleeds per 100 person-years.
 These oral anticoagulants are used widely as poisons for mammalian pests, especially rodents.
(For details, see rodenticide and warfarin.) Depletion of vitamin K by Coumadin therapy increases
risk of arterial calcification and heart valve calcification, especially if too much vitamin D is present
Available agents
 Warfarin (Coumadin) is the main agent used in the US and UK.
 Acenocoumarol and phenprocoumon are used more commonly outside the US and the UK.
 Atromentin

7. ANEMIA CAUSES AND TYPES OF
ANEMIA

8. TYPES OF ANEMIA
Anemia is caused by many different things at it has a lot of
subtypes. However, the main presenting factor is the lack of
healthy circulating red blood cells to carry oxygen systemically.
There are three main types of anemia,
 that due to blood loss.
 that due to decreased red blood cell production.
 and that due to increased red blood cell breakdown.
Grading of Anemia by conc. of Hb in blood, According
to (WHO), World Health Organization.

9. TYPES OF ANEMIA
Here is a quick overview of the different subtypes of anemia:
 1. Iron Deficiency Anemia
Iron is needed for healthy production of red blood cells. Iron is
a building block of healthy red blood cells. A deficiency in iron
would result in anemia.
 2. Folic-Acid Deficiency Anemia
This type of anemia results from a deficiency of Folic Acid,
also known as vitamin B.
 3. Thalassemia
Thalassemia is a form of anemia that is inherited. In this type of
anemia, the body makes an abnormal form it hemoglobin.
Comparison between amount of RBCs in
normal blood and anemic blood

10. TYPES OF ANEMIA
 4. Vitamin B12 Deficiency Anemia
This form of anemia is due to lack of sufficient cyanocobalamin or Vitamin B12.
 5. Hemolytic Anemia
Hemolytic Anemia is a type of anemia that results from excessive lysis or destruction of RBCs.
 6. Aplastic Anemia
In Aplastic anemia, there is a deficiency in sufficient production of red blood cells by the bone marrow.
 7. Sickle-Cell Anemia
This type of anemia is caused by a particular type of hemoglobin called hemoglobin S.

11. ANEMIA PATHOPHYSIOLOGY AND
SYMPTOMS

12. ANEMIA
SYMPTOMS OF ANEMIA

13. PATHOPHYSIOLOGY
The symptoms of anemia vary according to the type of anemia.
Symptoms common to many types of anemia
include the following:
 Fatigue
 Pallor
 Cyanosis
 Low hematocrit and RBC levels on a
Complete Blood Count
 Chest pain
 Dizziness and Headaches
 Paresthesia
 Skin mottling
 Shortness of Breath
 Confusion and restlessness
 Cold hands and feet
 Tachycardia

14. Thank you for your time!
End of Presentation