Obat hematologik

Heparin
Mekanisme kerja: + Antitrombin III SK / IV Ind: peny2 thromboemboli/lab/dialisis KI : peny prdarahan: HT,stroke,alergi, operasi SSP,alkoholisme,dll Efek lain: -penyembuhan luka -imunitas seluler, T4, aldosteron -lipotropik,dll

 F.kinetik: - IV/SK - metab: hati - waktu paruhdosis,peny hati, ginjal - tdk melalui placenta/ASI - ekskresi mel urin

Anticoagulan oral
Gol 4-hidroksikumarin: warfarin, dicoumarol Antagonis vit K Warfarin( wkt paruh 48 jam) Interaksi obat(meatau meefek warf) Indikasi/KI sama heparin Hati2 pd kehamilan hipoprotombinemi pd neonatus

Antithrombotik (antiplatelets)
ASPIRIN DIPYRIDAMOLE TICLOPIDINE CLOPIDOGREL

THROMBOLYTIC DRUGS
STREPTOKINASE UROKINASE Rt-PA

HAEMOSTATICS
TRANEXAMIC ACID(as. traneksamat) APROTININ ETHAMSYLATE CARBAZOCHROME SOMATOSTATIN/OCTREOTIDE ANTI HEMOPHILIC FACTOR DESMOPRESSIN

Asam traneksamat
Competitif inhibitor plasminogen aktivator Plasmin inhibitor Ind: prdarahan sal cerna, kemih,dll Antidot thd streptokinase/urokinase SP: hamil, laktasi, disfungsi hepatic/renal Dose: 0,5-1 gr 2-3 x/hari Interaksi: estrogen, beta-lactam Ab

Aprotinin
Suatu inhibitor enzim proteolitik(tripsin, plasmin, dll) Inaktivasi free plasmin Hambat aktivitas fibrinolitik dr plasminstreptokinase complex Ind: open-heart surgery(sirkulasi extra corporal), life-threatening haemorrhage akibat hiperplasminemia

 Inj 10.000 KIU/ml 50 ml Dosis: 50-100 ml (IV inj atau infus) max rate 10 ml/mnt. Kalau perlu 20 ml/jam sampai bleeding stop Interaksi: corticosteroid, heparin, asam amino(solution), tetrasiklin

Ethamsilate
Mencegah/terapi prdarahan kapiler Non vasoconstrictive/non fibrinolytic specialty Ind: cegah prdarahan pd kasus2 bedah, hematuria, hematemesis, melena, epistaxis, fragilitas kapiler, dll Dosis umum: 500mg 3x sehari

Somatostatin
Anti GH Ind:- sekresi eksesif tumor endokrin GIT - prdarahan akut/ hebat GIT(ulcus peptik) - haemorhagic gastritis prdrhan varices esophagus Dose: 250 mg IV(bolus) 3mg/12 jam 2-5 hari

Octreotide
somatostatin Anti GH Ind: - VIP-secreting tomours - bleeding gastro-esophageal varices Dose: - GEPE tumour: 0,05 mg SC 1-2x/hr - Bleeding varices: 25 mcg/jam 5 hr ( continuous IV infusion) Interaksi: ciclosporin, cimetidine

desmopressin
Synthetic vasopressin Ind: hemophilia A, von willebrand 1 Side effect: hipertension, headache flushing, nausea Dose: 0,3 mcg IV------ 15 min/2-3 days