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This presentation provides a comprehensive overview of anticoagulants, covering their classification, mechanisms of action, and therapeutic uses. It delves into the different types of anticoagulants, including parenteral and oral agents, and explores their pathways and adverse effects. The presentation also highlights the mechanism of action of key drugs like heparin and warfarin, providing valuable insights into their clinical applications.
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CONTENTS
Introduction
Classification of Anticoagulants
Pathways
Mechanism of action
Therapeutics Uses
Adverse Effects
Classification of Anti Coagulants 1) USED IN VIVO: A) PARENTERAL ANTICOAGULANTS: (a)INDIRECT THROMBIN INHIBITORS : Heparin Low molecular weight heparins Fondaparinux Danaparoid (b) DIRECT THROMBIN : Lepirudin Bivalirudin Argatroban
Bishydroxcoumarin (dicumarol) Warfarin sodium Acenocoumarol DIRECT FACTOR Xa INHIBITORS: Ethylbiscoumacetate Rivaroxaban ORAL DIRECT THROMBIN INHIBITOR: Dabigatran, etexilate
Pathways:
Mechanism of important drugs used in anti coagulatns: (^) ANTICOAGULANT ACTION OF HEPARIN: HEPARIN Activates plasma AT Il Heparin-AT Ill complex Binds to clotting factors of intrinsic and common pathways (Xa, la, IXa, Xla, Xlla and Xllla) and inactivates them
WARFARIN MOA:
Warfarin and its congeners act as anticoagulants only in vivo, not in vitro. This is so because they act indirectly by interfering with the synthesis of vit K dependent clotting factors in liver. They apparently behave as competitive antagonists of vit K and lower the plasma levels of functional clotting factors in a dose-dependent manner. In fact, they inhibit the enzyme vit K epoxide reductase (VKOR) and interfere with regeneration of the active hydroquinone form of vit K (Fig. 45.2) which acts as a cofactor for the enzyme γ-glutamyl carboxylase.
Fig:moa of oral anticoagulant
REFERENCE: “ESSENTIAL OF MEDICAL PHARMACOLOGY” TH Edition By KD Tripathi,Page no: