Used in Coagulation Disorders

Antithrombin III An endogenous anticlotting protein that irreversibly inactivates thrombin and factor X. Its enzymatic action is markedly accelerated by heparin 

Clotting cascade System of serine proteases and substrates in the plasma and tissues that provides for very rapid generation of clotting factors to prevent loss of Uood when damage occurs to a vessel 

Extrinsic pathway Factors in tissues that are important in triggering the clotting process 

Giycoprotein llb/llla A large protein complex located on the surface of platelets. When activated by binding to fibrin or several other ligands, it triggers platelet aggregation 

UVIW heparins Low molecular weight (LMW) heparins are preparations of heparin fractions of molecular weight 2000-6000. Regular heparin has a molecular weight range of 5000-30,000 

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Which one of the following statements about drugs used in coagulation disorders is false ... 

All NSAIDs are contraindicated in patients with active peptic ulceration and in those who have a history of hypersensitivity to any NSAID. They should be used with caution in older people (because of the risk of serious gastrointestinal side effects and drug-induced hepatitis), in allergic disorders including asthma, during pregnancy and in coagulation disorders. 

Hambleton, J. and O Reilly, R.A., Drugs used in disorders of coagulation, in Basic and Clinical Pharmacology, 8th ed., Katzung, B.G., Ed., Lange Medical Books/McGraw-Hill, New York, 2001, chap. 34. 

Immunodeficiency 100-200 mg/kg/mo IV at 0.01-0.04 mL/kg/min to 400 mg/kg/dose max UP 400 mg/kg/dose IV daily x 5 d BMP 500 mg/kg/wk X in renal insuff Caution [C, ] Separate administration of live vaccines by 3 mo Contra IgA deficiency w/ Abs to IgA, severe thrombocytopenia or coagulation disorders Disp Inj SE Associated mostly w/ inf rate GI upset Interactions X Effects OF live virus vaccines EMS May cause anaphylactic Rxn OD Unlikely Immune Globulin, Subcutaneous (Vivaglobin) [Immune Serum] Uses Primary immunodeficiency Action IgG supl Dose 100—200 mg/kg BW subq wkly abd, thighs, upp arms, or lat al hip Caution [C, ] Contra Hx anaphylaxis to immune globulin some IGA deficiency Disp Inj SE Inj site Rxns, HA, GI complaint, fevCT, N, D, rash, sore throat EMS May be self administered at home may cause anaphylactic Rxn OD Unlikely to cause life-threatening Sxs... 

Because it is stable, desmopressin is preferred for treatments especially if pressor effects are not desired. The primary indication for therapy is central diabetes insipidus, a disorder that results when ADH secretion is reduced and that is characterized by polydipsia, polyuria, and dehydration. Desmopressin is also used to reduce primary nocturnal enuresis, or bedwetting, in children. It is useful in people with mild hemophilia A or with some types of von Willebrand s disease, in which von Willebrand s factor is present at low levels. In these cases, desmopressin is given when excessive bleeding occurs or before surgery to help reduce bleeding indirectly by increasing the amounts of coagulation factors. 

AccessMedicine Print Chapter 34. Drugs Used in Disorders of Coagulation... 

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