STUDENT PROJECT

ANTICOAGULANT PHARMACOLOGY
I GEDE PUTRA ANGGA JAYA
2070121054
SGD 4

BLOK 2.4 HEMATOLOGIC AND IMMUNE SYSTEM

PROGRAM STUDI PENDIDIKAN DOKTER
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS WARMADEWA
 DEFINITION OF ANTIKOAGULAN

● It is a drug that prevents blood

clots
● Extending the time for blood to
clot
● Used to treat and prevent
blockage of blood vessels
 TYPES OF ANTIKOAGULAN

Heparin Warfarin LMWH Direct

Thrombin
Inhibitor
 HEPARIN

• It is a drug that affects blood

clotting in the body
• Works by bonding with
antithrombin III (heparin cofactor)
• The main side effects of heparin
are the occurrence of bleeding
and some other side effects.
HEPARIN PHARMACOLOGY
Pharmacodynamics Pharmacokinetic
• Works by increasing the effects
• It is given by intravenous
infusion or subcutaneous
of serine protease inhibitors
injection
•
(serpin) antithrombin
Bind to antithrombin enzyme
• Heparin excretion is carried
out through 2 mechanisms
inhibitors
• Heparin half-life increased
from 30 minutes
WARFARIN

• Used to treat and/or prevent

the formation of blood clots
(thrombus)
• Used as first-line therapy
• Prone to bleeding, necrosis,
allergies
 WARFARIN PHARMACOLOGY
Pharmacodynamics
• The effect comes from the cyclic
intervening inhibisis of vitamin K
• Requires a reduced form of
vitamin K
Pharmacokinetic
• Absorption → Through the
oral route and done quickly
and complete drcara
• Distribution → Volume 0.14
liters/kg
• Metabolism → Occurs in the
liver and consists of isomers
S and R
• Elimination → Through urine
with a half-life of 20-60 hours
 LMWH
• Inhibiting the Xa factor
• Increase TFPI from endothelial
• Have side effects of anemia,
thrombocytopenia, nausea, diarrhea,
allergies
• Increases the risk of bleeding when
used in conjunction with other
anticoagulants
• It has several advantages compared
to heparin
• Example → enoxaparin, dalteparin,
nadroparin, parnaparin, and
fondoparinux
 LMWH PHARMACOLOGY
(ENOXAPARIN)
Pharmacodynamics Pharmacokinetic
• Works by inhibiting lla and Xa
• Absorption → Fast and
• Inactivating the Xa factor
•
complete
• Increase thrombin time and
Distribution → Volume of
approximately 4.3L
activated partial thromboplastin
time
• Metabolism → Occurs in the
liver
• Elimination → Excretion
through the kidneys
DIRECT THROMBIN
INHIBITOR
• Inhibits free and bonded
thrombin
• Can prevent stroke and
thromboemboli
• Have a more stable
pharmacokinetic
• Side effects in the form of
gastrointestinal bleeding, and
some minor side effects and
rare side effects
 DIRECT THROMBIN INHIBITOR
PHARMACOLOGY (DABIGATRAN)
Pharmacodynamics Pharmacokinetic
• Directly inhibit thrombin activity
• Absorption → Biovailability
3-7%
• Inhibitors peptidomimetic • Distribution → After
thrombin reaching the peak of
• Has a benzylimidazolic nucleus plasma, it will decrease
• Symbiosis of the key roles of biphasically
thrombin • Metabolism → Occurs in
the liver
• Elimination → Excretion
through urine
 REFERENCE

Golan, D.E., Tashjian, A.H., Armstrong, E.J., and Armstrong, A.W. 2012. Principles of
Pharmacology: The Pathophysiologic Basis of Drug Therapy. 3rd ed. Philadelphia:
Lippincott Williams & Wilkins

Katzung, B.G., Masters, S.B., and Trevor, A.J. 2012. Basic & Clinical Pharmacology. 12nd
ed. New York: The McGraw-Hill
THANK
YOU
FOR YOUR ATTENTION