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Basic Process of Hemostasis (4):
- Vascular Phase
- Platelet Phase
- Coagulation Phase
- Fibrinolysis Phase
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Topical Hemostatics include (8):
- Thromboplastin
- Thrombin
- Fibrinogin
- Fibrin Foam
- GelFoam
- Oxidized Cellulose
- Microcrystalline Collagen
- Epi
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Systemic Hemostatics include (2):
- Desmopressin Acetate
- Protamine Sulfate
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In Vitro Anticoagulants (4):
- Sodium Oxalate
- Sodium Citrate
- Edetate disodium
- Heparine Sodium
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Anticoagulants used for transfusions (2):
- Acid Citrate Dextrose
- Citrate-Phosphate-Dextrose-Adenine
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Systemic Anticoagulants(2):
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Vit K antagonists include (4):
- Bishydroxycoumarin (Dicumarol)
- Warfarin Sodium / Parwarfin / Coumodin
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Fibrinolytic Agents(4):
- Streptokinase
- Tissue Plasminogen Activator
- Fibrinolysin
- Urokinase
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Anti-Platelet Drugs (4):
- Aspirin
- Ticlopidine
- Clopidogrel (Plavix)
- Dipyrimadole
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Thromboplastin converts ___ to ___
Prothrombin to Thrombin
-
-
Thrombin Converts ___ to ___
Fibrinogin to Fibrin
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Clinical Uses of Thrombin (6):
- Bleeding from Parenchymatous Tiss
- Cancellous Bone
- Dental Sockets
- Laryngeal/Nasal Sx
- Reconstructive Sx
- Adhesive Agent for Skin Grafts
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Various Forms of Thrombin:
- Powder
- Solution
- Foam
- Gelatin Sponge
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Admin of Thrombin:
NEVER IV!!!
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Fibrinogen requires endogenous ____ to convert into Fibrin
Thrombin
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Clinical Uses of Fibrinogen:
- Bleeding form denuded MM
- Skin Grafts
- Massive Blood Loss/Acute Hypofibrinogenemia
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____ must be presoaked in thrombin sol
- Fibrin Foam
- GelFoam (bovine thrombin)
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How do Fibrin Foams work?
They trap blood oozing at surface
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Which product can absorb several times its weight in whole blood?
- Absorbable Gelatin Sponges
- (GelFoam)
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Which topical hemostatic is antigenic?
GelFoam
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____ is applied to bleeding area, liquifies in 3-5 days and is absorbed in 4-6 weeks
GelFoam
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Used as a Sx gauze/Sponge
Oxidized Cellulose (Surgicel, Oxycel, Hemo-Pak)
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Oxidized Cellulose is intended to be used as a tempory packing b/c it can interfere with:
- Bone Regeneration
- Epithelialization
- Cyst Formation
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Which Topical Hemostatic has a greater affinity for wet surfaces and adheres firmly?
Microcrystalline Collagen
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Clinical Uses of Microcrystalline Collagen (2):
- Clotting Factor Deficiencies
- Liver or Sleep Sx
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Topical Hemostatic that provides immediate vasoconstriction
Epi
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Topical Hemostatic that acts as astringent
Styptics
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Which Topical Hemostatic can cause sloughing of tissue and hemorrhages?
Styptics
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Vit K aids in the production of which clotting factors?
-
-
Synthetic Analog of Vasopressin*
Desmopressin
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Functions of Desmopressin:*
- Releases Stored vWf from endothelium and MO
- Controls Cap bleeding
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Why does Vit K lose it's efficacy?
Because vWf has to be restored
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Anticoagulant that interferes with thrombin and fibrinogen:
Protamine Sulfate
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What drug can be used to antagonise Heparine Induced Hemorrhagic Action
Protamine Sulfate
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What drug has antithrombic and anticoagulatory properties?
Heparin
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Heparine Binds to ____, which induces a conformational change, which in turn inhibits ___ and activates ____
- ...binds to Antithrombin III Factor...
- ...Inhibits Thrombin...
- ...activates factor Xa...
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Heparine is metabolized by...
- Liver
- Reticulo Endothelial System
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Clinical Uses of Heparin (5):
- Prevention of Venous Thrombosis
- Prevention of Pulmonary Embolism
- Tx of Thromboemboli
- DIC in cats
- HW Tx
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Anticoagulant Action of Vit K antagonists become evident after ___, and are present for ___
-
Where are Vit K Antagonists....
stored:
Metabolized:
Liver (both)
-
Clinical Uses of Vit K Antagonists:
Prophylaxis/Tx of Venous Thrombosis
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Fibrinolytic Agents are used to enhance the conversion of ____ to active ____
...Inactive Plasminogen to active Fibrinolytic Enzyme Plasmin
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Duration of onset of streptokinase=
30mins - 12 hours
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Which Fibrinolytic Agent selectively acts on fibrin clots?
Tissue Plasminogen Activator
-
Clinical Uses of Tissue plasminogen Activator
Lysis of Aortic Thromboemboli
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What drug is administered IP as a lavage to prevent adhesions in dogs?
Urokinase
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Clinical Uses of Streptokinase (8):
Eczema
Dermatitis
Cellulitis
Hematomas
Trauma
Sinusitis
Cysts
Fractures w/ Fistulous Tracts
-
Clinical Use of Anti-platelet drugs (7):
- Thrombi associated w/ feline Cardiomyopathy
- Pulmonary Endocarditis in HW Dz
- DIC
- Pulmonary thromboembolism
- Laminitis
- Navicular Dz
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Aspirin irreversibly inhibits ___, which inhibits ___
Cyclooxygenase enzyme, which inhibits Prostaglandins & Thromboxane A2
-
What potent aggregating factor is inhibited by aspirin
Thromboxane A2
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Ticlopidine is a ____ inhibitor
P2Y12
-
What drug is structurally related to Ticlopidine
Clopidogrel (Clavex)
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Funciton of cAMP
antiaggregating compound
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