2012 Drugs that promote or inhibit coagulation

Adverse effects

• HEMORRHAGE

• flatulence and diarrhea are common

• decreased protein C causes cutaneous necrosis during first weeks of treatment that can progress (rarely) to infarction (venous thrombosis) in fatty tissues, intestine and extremities

• bone defects (chondrodysplasia punctata) and hemorrhagic disorders in infants born to mothers taking the drug during first trimester of pregnancy è ABSOLUTELY CONTRAINDICATED IN PREGNANCY

• DISEASE STATE and DRUG INTERACTIONS

WARFARIN has a NARROW THERAPEUTIC INDEX is NEARLY COMPLETELY (99%) BOUND TO PLASMA ALBUMIN is ELIMINATED BY HEPATIC METABOLISM (CYP450) à WARFARIN IS THE PROTOTYPE FOR DRUG-DRUG INTERACTIONS!

• Mechanisms of action
• Indirect thrombin inhibitors
  • ATIII Activators
    • Mechanism of action
    • Pharmacokinetics
    • LMW Heparins
    • Therapeutic uses
    • Adverse effects
    • Protamine sulfate
  • Factor Xa inhibitors
• DTIs
  • Mechanism of action
  • Pharmacokinetics
  • Therapeutic uses
  • Adverse effects
• Zymogen synthesis inhibitor
  • Mechanism of action
  • Pharmacokinetics
  • Therapeutic uses
  • Adverse effects
    • Interactions
    • Increased actions
    • Decreased actions
    • Drug interaction theory
    • Specific drug interactions
  • Phytonadione