Drugs affecting coagulation

Decreasing or increasing blood clotting,
are used in different fields of medicine. Especially widely used
received anticoagulants and other means used to
prevention of thrombosis and thromboembolism, often
arising after surgery, myocardial infarction,
other diseases. Recently developed specific
scheme long-term use of anticoagulants
(Antiplatelet therapy) for the prevention of thrombosis in patients undergoing
myocardial infarction.
Anticoagulant (antithrombotic) funds are divided into
3 groups: 1) Kantikoagulyanty; 2) Kfibrinoliticheskie means;
3) Kantiagregantnye means.
Anticoagulants are mainly prevent the formation of the filaments
fibrin, they prevent thrombosis, contribute
cessation of growth of clots already arisen, as well as the effects of
blood clots in the endogenous fibrinolytic enzymes.
Fibrinolytic agents cause destruction formed
fibrin strands; They contribute mostly fresh resorption
(Not yet subjected to the organization) clots.
Antiplatelet agents inhibit the aggregation of platelets and erythrocytes,
their ability to reduce the bonding and adhesion (adhesion) to
vascular endothelium. By reducing the surface tension
erythrocyte membranes, they facilitate their deformation when pro-
walking through the capillaries and improve the "flow" of blood. Antiag-
reganty able not only to prevent aggregation, and
cause disaggregation has aggregated blood platelets.
Anticoagulants are divided into 2 groups: a) direct anticoagulants -
Fast (short-term) actions; b) indirect anticoagulants -
long-acting. The first effective in vitro and in vivo.
Apply them parenterally. The second act only in vivo and effectiveness
fective if swallowed.
The main representative of anticoagulants of direct action
is Kgeparin and to indirect anticoagulants are
derivatives of 4-hydroxy-coumarin K (neodikumarin et al.) and fenilin-
dandiona (fenilin) ​​[The earlier the drug from the group
fenilindandiona K omefin excluded from the range of medicines
funds as having advantages over fenilinom].
Fibrinolytic agents also divided into groups and a direct
indirect action.
The first group includes substances that directly affect the
blood plasma, fibrin clot. They are effective in vitro and in
vivo. In the second group are activators of fibrinolysis. They
inactive by direct action on fibrin strands, but
administered to activate the endogenous fibrinolytic
blood system.
Representative of the drugs of the first group is the K fibrinolizin.
As activators of fibrinolysis (drugs of the second group)
used drugs Kstreptokinazy (of Ab protein -hemolytic
Strep A), including the preparation streptaza (domestic
drug streptoliaza immobilized drug streptokinase
Streptodekaza et al.). The main use as a fibrinoliti-
iCal funds currently have streptokinase preparations.
Applied also close by the action of a proteolytic enzyme
urokinase.
The inhibitory effect on the bonding (aggregation) of platelets (and
erythrocytes) have a greater or lesser extent drugs
agents of different pharmacological groups (organic nitrates,
antagonists of calcium ions, purine derivatives - protivogistaminnye
and other drugs.). Severe effects have antiagregatine
nonsteroidal anti-inflammatory drugs, including widely
application in order to prevention of thrombosis has
acetylsalicylic acid. They have the same properties
dipyridamole, pentoksifilin (Trental). New drugs in this group
It is ticlopidine (tiklid).
Also divided into groups and different mechanism of action
agents that increase blood clotting and providing
gemostaticheckoe action.
Protamine sulfate U - specific antagonist of heparin.
K aminocaproic acid and ambenom - fibrinolysis inhibitors.
K Fibrinogen and thrombin - natural components of the coagulation
blood system. KKaltsiya dobezila t attributable to the group
angioprotectors, has proagregatsionnoe action, increasing
platelet activity.
Several gemostaticheekih of plant origin found
use mainly on the basis of traditional medicine data.