Coagulants class lecture ppt

1. COAGULANTS
Suresh Kumar Ghritlahare
SRU, Raipur, (C.G.)

2. COAGULANTS
Coagulants: These are substances which
promote coagulation,and are indicated in
haemorrhagic states.
• Fresh whole blood or plasma provide all the
factors needed for coagulation and are the best
therapy for deficiency of any clotting factor;
also they act immediately.

3. Other drugs used to restore haemostasis are:
1. Vitamin K
• K1 (from plants fat-soluble), : Phytonadione
(Phylloquinone)
• K3 (synthetic)
• —Fat-soluble : Menadione, Acetomenaphthone
• —Water-soluble : Menadione sod. Bisulfite,
Menadione, sod. diphosphate
2. Miscellaneous
• Fibrinogen (human)
• Antihaemophilic factor
• Desmopressin
• Adrenochrome monosemicarbazone
• Rutin, Ethamsylate

4. VITAMIN K
• It is a fat-soluble dietary principle required for
the synthesis of clotting factors.
• Chemistry and source Vit K has a basic
naphthoquinone structure, with or without a
side chain (R) at position 3. The side chain in
K1 is phytyl, in K2 prenyl, while in K3 there is
no side chain.

5. • Dietary sources: are—green leafy vegetables,
such as cabbage, spinach; and liver, cheese, etc.
• Daily requirement: It is uncertain, because a
variable amount of menaquinone (vit K2)
produced by colonic bacteria becomes available.
Even 3–10 μg/day external source may be
sufficient. However, the total requirement of an
adult has been estimated to be 50–100 μg/day.
• Action: Vit K acts as a cofactor at a late stage in
the synthesis by liver of coagulation proteins—
prothrombin, factors VII, IX and X.

6. • Utilization: Fat-soluble forms of vit K are
absorbed from the intestine via lymph and
require bile salts for absorption, while water-
soluble forms are absorbed directly into portal
blood. An active transport process in the
jejunum has been demonstrated for K1, while
K2 and K3 are absorbed by simple diffusion.
• Deficiency: Deficiency of vit K occurs due to
liver disease, obstructive jaundice,
malabsorption, long-term antimicrobial
therapy which alters intestinal flora.

7. Preparations:
• Phytonadione: VITAMIN-K, KVI, K-WIN 10
mg/ml for i.m. injection.
• Menadione: 0.66 mg in GYNAE CVP with vit C
75 mg,
• ferrous gluconate 67 mg, Cal. lactate 300 mg
and citras bioflavonoid 150 mg per cap:
• Acetomenaphthone: ACETOMENADIONE 5,
10 mg tab; KAPILIN 10 mg tab.

8. Use :The only use of vit K is in prophylaxis and
treatment of bleeding due to deficiency of
clotting factors in the following situations:
• Dietary deficiency
• Prolonged antimicrobial therapy
• Obstructive jaundice or malabsorption
syndromes
• Liver disease (cirrhosis, viral hepatitis)
• Liver disease (cirrhosis, viral hepatitis)
• Newborns
• Overdose of oral anticoagulants

9. Adverse effects: Phytonadione injected i.m. or
given orally hardly produces any adverse
effect; allergic reactions are rare.
Reference: Tripathi KD, “Essentials of Medical
Pharmacology” published by Jaypee Brothers
Medical Publishers (P) Ltd, Seventh Edition:
2013, New Delhi, p.p. no-599-512.