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Blood Thinners - Coggle Diagram

- - - - greater systemic effect: not only in site but in circulation
        
        greater ADRs
      - Indirectly activates free and bound plasminogen
    - - not administered with anticoagulants
- - - - Aspirin
        
        Used in low doses
        
        prophylaxis for platelet clotting
        
        only type of NSAID drug that is not used for inflammation because it binds irreversibly to cox enzyme, and because platelets are non-nucleated, it cannot make new cox, this leads to an increase in ADR:bleeding. read notion article for more info
        
        Used in high doses
        
        treating inflammation
        
        Contraindication: gout
    - - Clopedogrel
        
        activates CAMP by inhibiting Gi pathway, which causes a decrease levels of Ca2+ which prevents platelet activation
    - - Dipyradamole
        
        Coronary vasodilator
        
        Blocks the enzyme that breaks down CAMP which leads to accumulation of CAMP levels which causes decrease in Ca2+ and hence no platelet activation
  - - - Abciximab
        
        can only be given IV
        
        it is a protein hence it will break down due to digestion if per oral
        
        monoclonal antibody against GP IIb/IIa
        
        ADR
        
        Thrombocytopenia
  - - - consisting of only platelet formation
  - - - STEMI,NSTEMI, unstable angina
        
        NSTEMI has white clot
        
        STEMI has red clot
- - - - Unfractionated
      - Reversed by protamine sulfate
      - Requires monitoring by aPTT
      - safe for pregnancy
      - activation of antithrombin III
      - Indication
        
        Atrial fibrillation ppl who requires cardioversion
    - - Fractionated
      - Fondaparinux
        
        only inhibits factor XA
        
        changes the binding site, non-competitive inhibition
      - Low molecular weight heparin (LMWH)
        
        Enoxaparin
      - Doesn't require monitoring
  - - - Peak effect is 3-4 days
        
        which is why it requires monitoring by aPT
      - Contraindication
        
        Pregnancy
      - Reversed by vitamin K
      - Reduced activation of clotting factors II, VII, IX, and X
      - ADR
        
        Heparin-induced thrombocytopenia
        
        immunological reaction causing low platelet count
    - - direct inhibition of thrombin
      - reversed by idarucizumab
    - - stroke prophylaxis
      - Venous thromboembolism prophylaxis
  - - - consisting of RBC,platelets,Fibrin mesh