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Anticoagulant, Antithrombotic and Anti-Platelet Drugs www.freelivedoctor.com
Clinical Thrombosis ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Indications For Antithrombotic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Recombinant Human Activated Protein C ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Antithrombin III Inhibits the Following Serine Proteases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Inhibitory activity against all these enzymes is substantially accelerated by heparin www.freelivedoctor.com
Heparin ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Anticoagulant Properties of Heparin ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Heparin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Unfractionated Heparin ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Monitoring of Anticoagulant Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Low Dose Unfractionated Heparin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Indications for and Contraindications to  Parenteral Anticoagulant Agents www.freelivedoctor.com Anticoagulant Agent Class Approved & Appropriate Indications Contraindication Unfractionated heparin Enoxaparin ( Lovenox ) Dalteparin ( Fragmin ) Tinzaparin ( Innohep ) Antithrombin III inhibitor Low-molecular-weight heparin Low-molecular-weight heparin Low-molecular-weight heparin Treatment of venous thromboembolism or unstable angina; used when rapid reversal is important Prophylaxis in moderate-risk or high-risk patients, treatment of venous thromboembolism or unstable angina Prophylaxis in moderate-risk or high-risk patients, treatment of venous thromboembolism or unstable angina Prophylaxis in moderate-risk or high-risk patients, treatment of venous thromboembolism ? Prophylactic treatment Regional anesthesia Pregnancy Prosthetic Heart Valves Regional anesthesia Regional anesthesia
Indications for and Contraindications to  Parenteral Anticoagulant Agents (cont’d) www.freelivedoctor.com Ardeparin Lepirudin Argatroban Danaparoid Bivalirudin Fondaparinux ( Arixtra ) Low-molecular-weight heparin Hirudin derivative Direct thrombin inhibitor Heparinoid Hirudin derivative Synthetic factor Xa inhibitor Approved; not being marketed Heparin-induced thrombocytopenia with thrombosis Heparin-induced thrombocytopenia with thrombosis Prophylaxis against thrombosis in heparin-induced thrombocytopenia Unstable angina or angioplasty Prophylaxis in high-risk patients? Regional anesthesia Thrombocytopenia other than heparin-induced thrombocytopenia Thrombocytopenia other than heparin-induced thrombocytopenia Thrombocytopenia other than heparin-induced thrombocytopenia Unknown Unknown
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Heparin-Antibiotic Interactions ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Mechanisms of HIT ,[object Object],[object Object],www.freelivedoctor.com
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Therapy of HIT ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Warfarin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Contraindications to Antithrombotic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Contraindications to  Antithrombotic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Contraindications to Antithrombotic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Platelet Receptor Mediated Pathways: Drugs www.freelivedoctor.com Arachidonic Acid ASA NSAIDs ADP Ticlopidine Clopidogrel Thrombin -Final Common Pathway -Promotes Platelet Adhesion (Fibrinogen, vWF) GP IIB/IIIA Inhibitors Abciximab (ReoPro) Eptifibatide (Integrilin) Tirofiban
Anti Platelet Drugs www.freelivedoctor.com Drug Mechanism Uses Aspirin Permanently inhibits COX-1 and COX-2 CAD Stroke-TIAs NSAIDs Reversibly inhibits COX-1 Limited Dipyridamole Inhibits PDE; increases cAMP TIAs Ticlopidine Clopidrgrel Inhibits ADP PlatAg;active metabolite TIAs;Stroke CAD;PVD

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Anticoagulant, antithrombotic and anti platelet drugs