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Blood Coagulation by Mind Map: Blood Coagulation
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Blood Coagulation

By: Mohammed Hamza Haneef



The process of forming blood clots


A process by which the clot is dissolved


blood clots that causes obstruction of a vessel; pathologic formation of thrombus


Deep venous thrombosis- causes pulmonary embolism


a broken piece of a thrombus

arterial thromboembolism

obstruct blood flow in coronary or cerebral arteries

Causes of thrombosis


plaque rupture initiantes platelet adhesion causing thrombosis


Tumors secrete cysteine protease which activates factor X of coagulation








high homocysteine levels

Caused by deficiency of folic acid, vitamin B6 and B12

estrogen containing contraceptives

Women of blood groups A,B, and AB are at high risk


like sepsisIncreased risk of venous thrombosis


Immobilization of bodily fluids due to many reasons (surgery, paralysis, heart failure, obesity, pregnecy.. etc)


Drugs that reduce clotting ability of the blood


15000 Da

derived from animal tissues

Not absorbed in the GI (given parenterally)

immediate onset of action

action, activates antithrombin III, inactivates coagulation enzyme thrombin (factor IIa), inhibits factor Xa, inhibit platelet aggregation (only high doses)

adverse effects, main, bleeding, thrombocytopenia, after several days, alopecia, skin necrosis at the site of SC injection, after 3 months, osteoporosis, diminished renal function, hypersensitivity, can cause hypoaldosteronism

Drug interactions, cautiously used with drugs that alters coagulation or platelet function, aspirin, phenylbutazone, dipyridamole, warfarin, antagonize the actions of, corticosteroids, insuline, ACTH, increase plasma levels of diazepam, some drugs may counteract it's action, antihistamins, intravenous nitroglycerin, propylene glycol, digoxin, tetracyclines

Therapeutic uses, prevention and treatment of DVT and PE, prevention and treatment of thrombosis after MI, used in postoperative to prevent thrombosis and PE


derived from animal tissues

short fragment heparin

1000 - 10000 Da

Not absorbed in the GI (given parenterally)

immediate onset of action

action, activates antithrombin III, inhibits factor Xa, has reduced ability to bind to plasma proteins, thus pharmacological effect are more predictable

advantages over heparin, better bioavailability, longer duration of action, predictable plasma levels, lower risk of bleeding and osteoporosis, loser incidence of thrombocytopenia

examples, enoxaparin, tinzaparin, deltaparin


1500 Da

Synthetic analog of heparin

otherwise it's the same as LMWHs


most wildly prescribed oral anticoagulant

action, interfering with synthesis of v.K dependent clotting factors in the liver, each factor is decreased 30-50% by the therapeutic dose of warfarin

kinetics, bioavailability is 100% orally or rectally, slow onset of action (1-3 days), response is measured by prothrombin time PT, PT returns normal after 5-7 days, metabolized by CYP2C9

adverse effects, hemorrhage, allergic reactions, GIT disturbance, teratogenicity

drug interactions, V.K1 oxide is used as specific antidote, NSAIDs increase the risk of bleeding, hepatic enzyme inhibitors increase plasma levels of warfarin, cimetidine, chloramphenicol, metronidazole, hepatic enzymes inducers increase the metabolism of warfarin, rifampicin, griseofulvin, less absorption with cholestyramine

miscellaneous agents, phenprocoumon, acenocumarol, dicoumoral, dabigatran etexilate, converted to dabigatran


inhibit platelet aggregationexample: aspirin

prostaglandin synthesis inhibitors

Example: aspirin

example: aspirin

irreversibly inhibit COX-1

effect lasts 7-10 days (new platelets)

75 mg/day is enough

reduces incidence of stroke and MI

phosphodiesterase inhibitor

inhibiting the enzyme phosphodiesterase, so cellular levels of cAMP are decreased- Example: Dipyridamole


inhibit platelet aggregation by increasing activity of PGI2

similar effect to aspirin but no risk of bleeding

ADP antagonists

antagonists of ADP on P2Y12 and prevent platelet aggregation - example: ticlopidine and clopidogrel

ticlopidine and clopidogrel

antagonists of ADP on P2Y12 and prevent platelet aggregation

ticlopidine is largely replaced with clopidogrel because it causes TTP

usual dose is 75mg/day

glycoprotein receptor antagonist

Example: abciximab


glycoprotein IIb/IIIa receptor antagonist

used to prevent platelet aggregation during and after coronary artery procedures

has short half-life

strong affinity

thrombolytic (fibrinolytic) agents

dissolves the fibrin mesh


activating plasminogen, formation of plasmin, dissolving the fibrin mesh

adverse effects


antigen, fever, skin rashes, rarely anaphylactic reactions




tissue plasminogen activator (t-PA)