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'.

Coagulation phase

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.

For systemic effect

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

 For more information see 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'.

Resources

  • MARTÍNKOVÁ, Dahlia. Pharmacology for medical students. 1. edition. Prague : Grada, 2007. ISBN 978-80-247-1356-4.