Hemostatics

Hemostatics are drugs supporting hemostasis in excessive bleeding. According to the place where they intervene in the hemostasis process, we divide them into:
 * vasoconstrictive',
 * platelet',
 * coagulant',
 * against fibrinolysis.

Vasoconstriction phase
Derivatives of vasopressin' and α-mimetic are used to artificially constrict the blood vessel and reduce its flow (or stop the blood flow completely).

Platelet phase
To facilitate adhesion and the formation of a primary plug - etamsylate'.

For local effect
Coagulation spongia containing fibrinogen and thrombin on the surface, after activation by endogenous coagulation factors, a fibrin network is formed, the spongia undergoes complete degeneration.

Coagulation factors
Most often given as a replacement for genetic diseases – Hemophilia A – factor VIII, Hemophilia B – factor IX. Both can be replaced by administration of fresh plasma or factor concentrates.

K-dependent factors II, VII, IX, X are given in case of overdose with oral anticoagulants (Warfarin), liver diseases, broad-spectrum ATB treatment. The so-called PIVKA is created.

Vitamin K
It occurs naturally in plants, in the human body it is formed by saprophytic bacteria in the intestine. K-dependent coagulation factors – II, VII, IX, X.

Indication:
 * prevention or treatment of bleeding,
 * prevention of neonatal hemorrhage,
 * excessive use of oral anticoagulants,
 * sprue, celiac disease, steatorrhea, absence of bile in the duodenum (obstructive icterus).

Protamine sulfate
Protein, heparin antagonist (forms irreversible complexes with heparin). It is administered according to the estimate of residual heparin in the body, as it has an anticoagulant effect in higher doses.

Phase of fibrinolysis
'Antifibrinolytics act at the level of:
 * inhibition of plasminogen activators – k. tranexam, k. aminocapronic,
 * direct inhibition of plasmin - aprotinin'.

Related Articles

 * Coagulation
 * Coagulation versus agglutination
 * Anticoagulants