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Coagultaion summary including drugs affecting coagulation

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in depth summary of coagulation and summaries of drugs

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  • 21 de mayo de 2023
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  • 2022/2023
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Drugs Affecting Coagulation
Haemostasis definition✅
Vasoconstriction✅
Temporary platelet plug✅
Blood clotting✅
Retraction✅
Haemophilia✅
Vitamin k deficiency✅
Prostacyclin✅
DVT, VTE and PE`✅
Thrombosis✅
Heparins✅
Hirudins✅
Warfarin✅
Thrombin inhibitors✅
Aspirin ✅
anti-platelet✅
fibrinolysis✅




Haemostasis
 Prevents blood loss after damage to a vessel.
 There are 4 stages for coagulation.

Vasoconstriction




 Smooth muscle contracts/vascular spasm.
 Vessel narrows.
 Prevents blood loss.
 Less blood flows to the area.
Platelets also secrete epinephrine and serotonin which also increases vasoconstriction.

Temporary Platelet plug




 Platelets circulate the bloodstream.
 When activated they stick together.
 Platelets also secrete chemicals that attract other cells, in the clotting process, to the site of
injury.
 Von Willebrand Factor (vWf) is secreted by the platelets and subendothelial tissue (when
exposed due to damage).
 When damaged the collagen fibres on the subendothelial tissue binds to vWf.

,  This anchors the platelets in place.
 And causes platelets to secrete more of these chemicals to start the coagulation process.
 Positive feedback loop.
 ADH= released by platelets to cause them to adhere to each other and show the change in
the platelets in the diagram above.
 More is secreted every time platelets adhere=positive feedback
 ADH also stimulates thromboxane A2 production which also has platelet aggregation
properties.
 Platelet plug is limited to the area of the damaged vessel to prevent unnecessary blood clots.

Blood clotting




 A clotting factor cascade.
 To form a fibrin clot.
 When activated they form peptide bonds.
Intrinsic pathway: 12 activates 11 activates 9 activates 10.
Extrinsic: using calcium, 7 is activated to activate 10.
 Thrombin converts fibrinogen to fibrin monomers.
 These monomers form fibrin polymers
 Which forms a mesh to trap erythrocytes.

Clot Retraction
Plasmin=dissolves the clot
 Protein derived from plasminogen.
 Breaks down fibrin.
 Plasminogen activators are released by different cells to start this process.
 Stops blockages for too long.

Haemophilia
 Insufficiency in the intrinsic pathway
 Due to a reduction of one of the factors
A: loss of factor 8
B: loss of factor 9

Vitamin K deficiency
 Certain factors that are used in coagulation are not carboxylated.
 This can lead to reduced blood clotting.
 Naturally occurring in plants and in the gut
 Essential in the formation of clotting factors
Vitamin K activates gamma-glutamyl carboxylate which adds a carboxyl group to allow
calcium ions to bind to the clotting factors to activate them.

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