Clicking moves left

Enhanced Elimination in Toxicology

Enhanced Elimination in Toxicology Extracorporeal eliminationExtracorpore [...]

Decontamination in Toxicology

Decontamination in ToxicologyorHow to Decontamination in ToxicologySingle-dose [...]

Resuscitation in Toxicology

Resuscitation in ToxicologySupportive careInitial resuscitation should be based [...]

Key investigations of Toxicology

Key investigations of Toxicology In this topic: Electrocardiography Drug conce [...]

Arterial blood gases in Toxicology

Arterial blood gases in Toxicology Arterial blood gases are an important in [...]

Clicking moves right
M O V I E
TRAVELING
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as [...]

Pharmacology of Ranolazine
31 Mar 2012 0 comments

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combinati [...]

Pharmacology of Milrinone
31 Mar 2012 0 comments

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharma [...]

Pharmacology of Midodrine
31 Mar 2012 0 comments

Pharmacology of Midodrine   Indication For the treatment of symptomatic orthostatic hypotension [...]

Pharmacology of Dofetilide
31 Mar 2012 0 comments

Pharmacology of Dofetilide  Indication For the maintenance of normal sinus rhythm (delay in time to [...]

GALLERY
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu [...]

Post-Traumatic Stress Disorder
10 Mar 2012 0 comments

Post-Traumatic Stress DisorderPost-traumatic stress disorder develops following a traumatic event that elicit [...]

Social Anxiety Disorder
10 Mar 2012 0 comments

Social Anxiety DisorderSocial anxiety disorder, formerly known as social phobia, is characterized by an inten [...]

TOP LINE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, post-traumatic stress disorder. Click to view each type....

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Panic Disorder
Generalized Anxiety Disorder
REVIEW
Hormonal contraceptives
25 Apr 2011 0 comments

Hormonal contraceptivesHormonal contraceptives inhibit ovulation. Contraceptives typically contain a combination of hormones. Fo...

Erectile dysfunction therapy drugs

Erectile dysfunction therapy drugsErectile dysfunction therapy drugs treat penile erectile dysfunction that results from a lack ...

Urinary tract antispasmodics

Urinary tract antispasmodicsUrinary tract antispasmodics help decrease urinary tract muscle spasms. They include darifenacin, fl...

ANALYSIS
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as sustained ventricul...

Pharmacology of Ranolazine

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combination with amlodipine, ...

Pharmacology of Milrinone

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharmacodynamics Milri...

HIGHLIGHT
[ more from label ]
Classification of Anxiety Disorders
Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Latest News Updates
PERFORMANCE
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as ...

Pharmacology of Ranolazine
Pharmacology of Milrinone
FEATURE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu...

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Home » , » Oral anticoagulants
Oral anticoagulants
Tuesday, April 5, 2011 Posted by Piscean

Oral anticoagulants
The major oral anticoagulant used in the United States is the coumarin compound warfarin.


Pharmacokinetics
Warfarin is absorbed rapidly and almost completely when it’s taken orally. It binds extensively to plasma albumin and is metabolized in the liver and excreted in urine. Although warfarin is absorbed quickly, its effects don’t occur for about 48 hours, with the full effect taking 3 to 4 days.
Because warfarin is highly plasma-protein-bound and is metabolized by the liver, administration of warfarin with other medications may alter the amount of warfarin in the body. This may increase the risk of bleeding or clotting, depending upon the medications administered.

Pharmacodynamics
Oral anticoagulants alter the ability of the liver to synthesize vitamin K’dependent clotting factors, including prothrombin and factors VII, IX, and X. However, clotting factors already in the bloodstream continue to coagulate blood until they become depleted, so anticoagulation doesn’t begin immediately. 
 
Pharmacotherapeutics
Oral anticoagulants are prescribed to treat or prevent thromboembolism. Patients with this disorder begin taking the medication while still receiving heparin. However, outpatients at high risk for thromboembolism may begin oral anticoagulants without first receiving heparin.
Deep in the veins
 
Oral anticoagulants are also the drugs of choice to prevent DVT and for patients with prosthetic heart valves or diseased mitral valves. To decrease the risk of arterial clotting, oral anticoagulants are sometimes combined with an antiplatelet drug, such as aspirin, clopidogrel, or dipyridamole.
Monitoring warfarin levels
 
Patients taking warfarin need close monitoring of prothrombin time and International Normalized Ratios to make sure they are maintaining therapeutic levels of the drug. If laboratory results fall outside the accepted range, warfarin dosage should be adjusted.
Drug interactions
Many patients who take oral anticoagulants also receive other drugs, placing them at risk for serious 
 
drug interactions.
  • Many drugs, such as highly protein-bound medications, increase the effects of warfarin, resulting in an increased risk of bleeding. Examples include acetaminophen, allopurinol, amiodarone, cephalosporins, cimetidine, ciprofloxacin, clofibrate, danazol, diazoxide, disulfiram, erythromycin, fluoroquinolones, glucagon, heparin, ibuprofen, isoniazid, ketoprofen, methylthiouracil, metronidazole, miconazole, neomycin, propafenone, propylthiouracil,quinidine, streptokinase, sulfonamides, tamoxifen, tetracyclines, thiazides, thyroid drugs, tricyclic antidepressants, urokinase, and vitamin E.
  • Drugs metabolized by the liver may increase or decrease the effectiveness of warfarin. Examples include barbiturates, carbamazepine, corticosteroids, corticotropin, mercaptopurine, nafcillin, hormonal contraceptives containing estrogen, rifampin, spironolactone, sucralfate, and trazodone.
  • The risk of phenytoin toxicity increases when phenytoin is taken with warfarin, and phenytoin may increase or decrease the effects of warfarin.
Other interactions include the following:
  • A diet high in vitamin K reduces the effectiveness of warfarin.
  • Chronic alcohol abuse increases the patient’s risk of clotting while taking warfarin. Acute alcohol intoxication increases the risk of bleeding.
  • Vitamin K and fresh frozen plasma reduce the effects of warfarin. 
Warning!
Adverse reactions to oral anticoagulants
The primary adverse reaction to oral anticoagulant therapy is minor bleeding. Severe bleeding can occur, however, with the most common site being the GI tract. Bleeding into the brain may be fatal. Bruises and hematomas may form at arterial puncture sites (for example, after a blood gas sample is drawn). Necrosis or gangrene of the skin and other tissues can occur.
Quick fix
The effects of oral anticoagulants can be reversed with phytonadione (vitamin K1).

Piscean

Thanks for your visit..!

0 comments for "Oral anticoagulants"

   

Leave a reply

    March - 2025
    SMTWTFS
          1
    2345678
    9101112131415
    16171819202122
    23242526272829
    3031