PHRM3011 Lecture Notes - Lecture 10: Fibrin, Nonsteroidal Anti-Inflammatory Drug, Prothrombin Time
Document Summary
30-50ml/min = amiodarone then 220mg d dose reduction (150mg d) Conflicting results, has only a weak effect in vts prophylaxis, better agents available for use. Thrombocytopenia = heparin induced thrombocytopenia syndrome (hits) type 1 first few days: platelets stay >100x10^9/l, transient and reversible type 2 stop heparin, platelets <1000x10^9/l 5-15 days, heparin + antibodies complex platelet aggregation. Venous thrombi low flow and low shear stress. 28: mainly fibrin strands, rbc and few platelets. Arterial thrombi: high flow and high stress, mainly fibrin strands and platelet rich. Binds to antithrombin catalyses inactivation of particularly xa due to smaller size of lmwh why these rapid onset, prevent clot extension and pulmonary embolus, reduce mortality. Effects clotting factors 2,7,9 and 10 (all aus tv channels) Dose depends on how active enzymes are (cyp2c9, 4f2, 2c9) Two phase action inhibits vii within 24 hours: anticoagulant effect inhibits ii within 48-60 hours, antithrombotic effects risk period for thrombus extension if heparin is discontinued.
