Medical Pharmacology Chapter 39: Drugs that Influence Coagulation
Coagulation and Fibrinolysis: Regulation
Regional blood coagulation must be discreet in order to:
Not impair blood flow excessively
Avoid disseminated clotting
Inactivation of coagulation proteins (away from injury site)
Obstetrical emergencies (abruptio placentae; bacterial sepsis)
Major tissue injury
Cell lysis: neoplastic disease
Major process: conversion plasminogen (inactive) → plasmin (proteolytic enzyme, active)
Plasminogen activators: released from damaged cells
Limits thrombosis extension (by proteolytic fibrin digestion)
Primary Reference: O'Reilly, R.A. Drugs Used in Disorders of Coagulation, in Basic and Clinical Pharmacology, (Katzung, B. G., ed) Appleton-Lange, 1998, pp 916-940
Handlin, R.I. Bleeding and Thrombosis, In Harrison's Principles of Internal Medicine 14th edition, (Isselbacher, K.J., Braunwald, E., Wilson, J.D., Martin, J.B., Fauci, A.S. and Kasper, D.L., eds) McGraw-Hill, Inc (Health Professions Division), 1998, pp 339-344.
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