Title of the learning unit: Drugs affecting hemostasis

Impact of the learning unit:

Gaining knowledge about the possibilities how to pharmacologically interfere with the process of
hemostasis, what pharmacotherapeutic targets and the possible side effects for each drug classes
expected.

Important terms

anticoagulants

                interfering directly with the process of hemocoagulation

                                heparin and its derivatives

                                               unfractionated heparin (UFH)

                                               low molecular weight heparin (LMWH)

                                                               dalteparin

                                                               enoxaparin

                                                               nadroparin

                                               protamine sulfate

HIT

aPTT

                               thrombin inhibitors

                                               dabigatran

idarucizumab

                               direct factor Xa inhibitors

                                               rivaroxaban

                                               apixaban

                                               edoxaban

                vitamin K antagonists

                               warfarin

                               INR

fibrinolytics / thrombolytics

                alteplase

                reteplase

                tenekteplase

antifibrinolytics

tranexamic acid
aminomethylbenzoic acid

antiplatelet agents

                                COX inhibitors

                               ASA

                               indobufen

                drugs increasing the level of cAMP by inhibiting phosphodiesterase

                               dipyridamole

                               cilostazol

                               pentoxifyline

                drugs inhibiting the formation of fibrinogen bridges between plateles

                               by blocking P2Y12 purinergic receptor for ADP

                                               thienopyridines

                                                               ticlopidine

                                                               clopidogrel

                                                               prasugrel

                                               non-thienopyridines

                                                               ticagrelor

                                                               cangrelor

                               by blocking glycoprotein IIb / IIIa receptor for fibrinogen

                                               eptifibatide

                                               abciximab

                thrombin receptor PAR-1 antagonists

                               vorapaxar

hemostatics

                with vasoconstrictor effect

                               etamsylate

                               terlipresin

                without vasoconstrictor effect

carboxycellulose
firbrine sealant
bi-component tissue adhesives (fibrinogen + aprotinin with thrombin)
gelatin, gelatin sponge

antianemics

                iron

                               orally - iron salts

                               injection-iron salts

                vitamin B[12]

folic acid

haemopoietic growth factors

                erythropoetin

                               epoetin

                darbepoetin


Learning outcomes

Student knows to name the various drug groups affecting hemostasis.

Student knows the basic pharmacological profile (mechanism of action, side effects, indications and
contraindications) of anticoagulants.

Student knows the basic pharmacological profile (mechanism of action, side effects, indications and
contraindications) of antiplatelet agents

Student knows the basic pharmacological profile (mechanism of action, side effects, indications and
contraindications) of fybrinolytics and antifibrinolytics.

Student knows the basic pharmacological profile (mechanism of action, side effects, indications and
contraindications) of hemostatics and antianemics.

Study literature

Rang & Dale's Pharmacology E - Book, Humphrey Rang 8th edition, 2016, chapter 24, str. 293

Study materials to subjects aVLFA0822c  and aVLFA0822p.


Exam questions

Special pharmacology: 38. Antiplatelet drugs, 39. Fibrinolytics and antifibrinolytics, 40.
Anticoagulants, 41. Antianemics, hemostatics

“Essential” drugs: 88. warfarin, 89. enoxaparin, 90. clopidogrel, 91. dabigatran, 92. rivaroxaban,
93. alteplase