Coagulants

Definition of Coagulants:

Coagulants are agents that promote clotting, used in conditions where there is a deficiency or dysfunction in the clotting cascade.

1. Vitamin K:

   • Mechanism: Essential for γ-carboxylation of certain glutamate residues in clotting factors II, VII, IX, and X, as well as proteins C and S.
   • Use: Vitamin K deficiency, warfarin reversal, hemorrhagic disease of the newborn.
   • Side Effects: Generally safe; hypervitaminosis K is rare.

2. Prothrombin Complex Concentrates (PCC):

   • Mechanism: Provide concentrated clotting factors II, VII, IX, and X.
   • Use: Urgent reversal of warfarin anticoagulation, warfarin-induced bleeding.
   • Side Effects: Thrombosis risk, allergic reactions.

3. Fresh Frozen Plasma (FFP):

   • Mechanism: Contains all coagulation factors.
   • Use: Multiple factor deficiencies, liver disease, massive transfusion protocols.
   • Side Effects: Transfusion-related acute lung injury (TRALI), allergic reactions, volume overload.

4. Desmopressin (DDAVP):

   • Mechanism: Releases von Willebrand factor and factor VIII from endothelial cells.
   • Use: von Willebrand disease, mild hemophilia A.
   • Side Effects: Hyponatremia, fluid retention.

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