Diploma in Pharmacy 2nd yr PHARMACOLOGY chapter no 6 notes.pdf

Detailed notes of Drugs Acting on blood and Blood forming Organs,Anti-Platelet Agents,Thrombolytic Drugs (Fibrinolytics)

1. PHARMACOLOGY
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DiplomainPharmacy2ndyr
DrugsActingonbloodandBloodformingOrgans
→Bloodisafluidconnectivetissuethattransportsoxygen,nutrientsandgrowthfactorsto
individualcellsofthebody.
→Themaincomponentsofbloodarecell(likeRBCs,WBCs,platelets),proteins(like
coagulationfactors,aminoacids,growthfactors,factorsofthecomplementsystem),
monosaccharide(ribose,glucose),minerals(Na+,K+,Cl-,HCO3-),andwater.
→HaematologicSystem:ThesystemresponsibleforformationofbloodiscalledHaematologic
System.
→Haematopoiesis:TheprocessofbloodformingiscalledHaematopoiesis.
BloodFormingOrgans
➤BoneMarrow:Bonemarrowcontainscellsthatproducebloodcellsandplateletsanditis
responsibleformakingbillionsofnewbloodcellseachday.
➤Spleen:Thespleenstoresandfiltersbloodandmakeswhitebloodcellsthatprotectyoufrom
infection.
Liver:Theliverproducesproteinsthatareimportantinbloodclotting.Itisalsooneoftheorgans
thatbreakdownoldordamagedbloodcells.
Hematinicagents
→ThedrugsareusedtotreatAnaemiaarecalledHaematinics.ate
Or
→ThesubstancesareusedtotreatdeficiencyofIronarecalledhaematinics.
Anaemia
●Anaemiaisthedecreaseinnumberofredbloodcellsorhemoglobincontentcausedby
bloodloss,deficienterythropoiesis,excessivehemolysis,orcombinationofthese
changes.
●Irondeficiencyanaemiaisprobablythemostcommonnutritionaldeficiencyintheworld
TypesofDrugsareusedasHaematinics:
●Iron:FerrousSulfate,FerrousFumarate,FerrousAmmoniumCitrate,
●Folicacid:leucovorin,Citrovorum

2. PHARMACOLOGY
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●Others:Pyridoxine,Riboflavin.
PharmacologicalAction
1)Heparin:
●Itpreventbloodclottinginvivo(insidethebody)aswellasinVitro.
●ItActivatesantithrombinIII,whichinactivatesfactorsIX,andX.inthiswaycoagulationis
prevented.
2)Coumarin:
●CoagulationfactorsII,VII,IXandXarepresentininactiveform,untiltheyare
carboxylated.
●ThesedrugsactonVitaminKandpreventthesynthesisofchemicalthatcarboxylate
thesefactors.
Indications
●Lowbloodplatelets.
●Bleeding
●Inunstableangina.
●TopreventcoagulationinHeartfailure.
●Topreventclottingduringopenheartsurgery.
Contraindications
●Recenttrauma,
●Recentsurgery,Recentabortion.
●Recentstroke,
●SevereHypertension,
●SevereDiabetes,
●Severeliverdamage,
●Pepticulcer,
Bleedingdisorder.
Doses
●Heparin5000-10000unit/mli.v
●Warfarin5-10mg/d

3. PHARMACOLOGY
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DiplomainPharmacy2ndyr
Anti-PlateletAgents
→ThedrugspreventplateletaggregationarecalledAnti-Plateletdrugs.
→AlsoKnownasAnti-ThromboticDrugs
→Plateletaggregation,theprocessbywhichplateletsadheretoeachotheratsitesofvascular
injury,haslongbeenrecognizedascriticalforhemostaticplugformationandthrombosis.
Classification
➤Thromboxan(TxA2)synthesisInhibitors:LowdoseofAspirin,Dazoxiben.
➤PhosphodiesteraseInhibitors:Dipyridamol.
ADP-InducedPlateletAggregationInhibitors:Ticlopidine,Clopidogrel.
GlycoproteinIIb/IIIareceptorBlockers:Tirofiban,Eptifibatide.
PharmacologicalAction
Thromboxan(TxA2)synthesisInhibitors:LowdoseofAspirin.actsonCoxiandreducesthe
productionofTXA2.(thisTxA2causesplateletaggregation)
PhosphodiesteraseInhibitors:Dipyridamol.Itincreasestheconcentrationofcyclicadenosine
monophosphate(cAMP)levelsanditpreventsplateletaggregation.
ADP-InducedPlateletAggregationInhibitors:Ticlopidine,Clopidogrel.ItblocksthePa
activatestheplateletsandcauseaggregation.
Y12receptorofplatelet,whichGlycoproteinIIb/IllareceptorBlockers:Tirofiban,Eptifibatide.
TheyblockGlycoproteinIIb/Illareceptorofplateletwhichactivatesplateletaggregation.
Indications
AsaAnti-Platelet
Unstableangina
AcuteMI
InPostMIPatients
CerebrovascularDiseases

4. PHARMACOLOGY
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DiplomainPharmacy2ndyr
Prostheticheartvalves(artificialvalve)
Contraindications
●Severediabetes
●Liverdamage
●Pepticulcer
Dose
●Aspirin75-150mg/doral
●Dipyridamol150-300mg/d
●Ticlopidine250-500mg/d
●Tirofiban0.4mcg/kg/mini.v.
ThrombolyticDrugs(Fibrinolytics)
→AlsoKnownasFibrinolytics.
→Thesearethosedrugswhichareusedtobreakstheclot/thrombus,insidethebloodvessels(
mainlyincoronaryartery)
→Thegivetheiractionbyactivatingfibinolyticsystem.
Classification
1.Non-fibrinspecific
●Streptokinase
●Anistreplase
●Urokinase
2.Fibrinspecific
●TissueplasminogenActivators(t-PA)
●Alteplase
●Reteplase
●Tenecteplase

5. PHARMACOLOGY
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DiplomainPharmacy2ndyr
PharmacologicalActions
●Thrombolyticworkbydissolvingamajorclotquickly.
●Thishelpsrestartbloodflowtotheheartandhelpspreventdamagetotheheartmuscle.
●Thrombolyticcanstopaheartattackthatwouldotherwisebelargerorpotentiallydeadly.
Indication:
●Stroke
●MyocardialInfarction
●Usedfordissolvingtheclotting
Contraindications:
●Pregnancy
●Bleedingdisorder
●Diabetics
●Cardiovasculardisorder
Doses
✔Urokinase4400IU/kg
✓AlteplaseForMl15mgi.v.Forpulmonaryembolism100mgi.v
✓Streptokinase250,000IU/2ml