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Antiaggregants

Terms in this set (9)

-Warfarin:
Indirect anticoagulant
Synthetic analogue of Natural origin (Spoiled Sweet Clover Hay) Dicumarol antagonist of Vitamin K
Vitamin K can be in 3 Forms: Epoxide (inactive)
Quinone and Hydroquinone (active).
tranaformation of Hydroquinone into Epoxide Activates Carboxylase resulting in y-Carboxilation of 2,7,9,10 Coagulation factors and Protein S and C.
Warfarin inhibits Epoxyreductase enzyme thus Vitamin K does not transform into Hydroquinone form.
Factors 2,7,9,10, Protein S and C are not Carboxylated.
Acarboxy-factors can not participte in Coagulation cacade
Interaction with other Drus Groups:
Drugs with high affinity to plasma proteins Increase the Level of Warfarin in Plasma
Warfarin compete with thise drugs that are Eliminated by Cytochrome p-450, leading to changes in drugs' blood concentration
Drugs that Decrease Anticoagulant activity of Warfarin:
Cholestiramine
Barbiturates
Carbamazepine
Phenytoin
Rifampin
Vitamin K
(VR PC B)
Drugs that Increase Anticoagulant activity of Warfarin:
Chlor Hydrate
Amiodarone
Clopidorgrel
Ethanol
Fluconazole
Fluoxetine
Metroinidazole
Testosterone
(TEAMF + Clpoidogrel)
Side Effects:
1-Bleeding: Treatment with Warfarin should be Momitored with Rapid Injection of Fresh Frozen Plasma that contains 2,7,9,10 Factors
2-Paradoxical Necrosis of Soft Tissues:
Fomation of thrombi in Capilaries
Rapid Decrease of C and S anticoagulant proteins level
Especially in people with genetic deficit
In emergcy to prvent thrombosis Heparin should be given
Contraindications:
Pregnancy, Warfarin can oenetrate through Placental Barrier resulting in Bleeding.
Disturbances in Bone Formation in Newborns due to administration in Pregnancy (Teratogenic)