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Classification of commonly used hemostatic drugs

1. Hemostatic drugs acting on blood vessels

2. Antifibrinolytic drugs

3. Thrombin

4. Drugs to promote coagulation factor activation

Five, Others

1. Hemostatic medicine that acts on blood vessels

posterior pituitary

Application: rupture and bleeding of varicose veins in the esophageal gastric fundus, ulcers, acute gastric mucosa damage, cardia mucosa tear.*

Pharmacology: Contains vasopressin and oxytocin. Vaccination causes the mesenteric artery and hepatic artery to constrict, reduce the blood flow of the portal vein and hepatic artery, and reduce the portal pressure. (Note: It can constrict coronary artery, coronary heart disease, hypertension, heart failure and pulmonary heart disease to use with caution).

Usage: Add gs    40ml     iv, then add gs   500ml       ivgtt (10-20 drops per minute) for 72 hours. If necessary, add 5-10mg nitroglycerin.

Norepinephrine

Application: Local hemostasis.

Pharmacology: It acts on the small arteries and capillaries of the gastrointestinal mucosa, causing them to contract strongly.

Usage: 16 mg dissolved in 200ml frozen ns, 50ml/time, and take orally every 2-4 hours; or 200ml is dripped into the gastric tube. If bleeding is more than 3 times after 30 minutes, you can repeat it 1-3 times.

Somatostatin

Application: upper gastrointestinal bleeding, pancreatitis.

Pharmacology: Selectively act directly on the smooth muscle of the internal organs, causing its blood vessels to contract, thereby reducing portal venous blood flow and reducing portal venous pressure; inhibiting the pathological secretion of gastrointestinal hormones.

usage:

1. Major bleeding in the upper gastrointestinal tract, mainly esophageal varicocele bleeding: start by pushing 250μg (i.e. 3mg) (within 3-5min), followed by 250μg/h intravenous drops. After stopping the bleeding, the medication should be given continuously for 48-72h.

2. Pancreatic, gallbladder, intestinal fistula: 250μg/h intravenous drop until the fistula is closed, and then use it for 1-3 days after closing.

3. Acute pancreatitis: 250μg/h, 72-120 hours in a row; for 5 days in a row to prevent pancreatic surgery complications; for those who undergo ERCP examination, they should start using this product 2-3 hours before the operation.

Kabaquelo/Carlo Sodium

Application: bleeding caused by increased capillary permeability, such as itp, retinal bleeding, chronic pulmonary bleeding, gastrointestinal bleeding, nose bleeding, hemoptysis, hematuria, hemorrhoid bleeding, uterine bleeding, and cerebral hemorrhoids.

Pharmacology: Reduce capillary fragility, increase capillary resistance to damage, and shorten hemostatic time.

Usage: 5-10mg    bid/tid   im; severe bleeding 10-20mg    q2-4h    im.

Phenol sulfoethylamine (hemostatic sensitivity)

Applications: 1. Prevent and treat bleeding before and after the operation; 2. Thrombocytopenic purpura (ttp,itp), allergic purpura (hsp    ); 3. Bleeding due to other causes (including gastrointestinal bleeding).

Pharmacology: Reduce capillary permeability, causes vasoconstriction, shortens bleeding time, and enhances platelet aggregation and adhesion.

Usage: ivgtt, 4-8g per day, 2 times.

2. Antifibrinolytic drugs

Tengexyl acid

Applications: 1. Bleeding caused by hyperfibrinolysis; 2. Treatment for severe bleeding caused by excessive thrombolysis.

Pharmacology: Competitively inhibits the binding of lysine of fibrin to plasmin, inhibits the cleavage of fibrin clots, and produces a hemostatal effect. The hemostatal effect is 6-10 times stronger than aminoacetic acid.

Usage: po: 1g-1.5g at a time, 2-4 times a day;

ivgtt: 0.25g-0.5g at a time, 0.75-2g a day.

Toluene acid (hemostatic acid)

Applications: 1. Bleeding caused by hyperfibrinolysis; 2. Bleeding caused by excessive streptokinase, urokinase, and tissue plasminogen activator (t-pa).

Pharmacology: With the same tranexamic acid, the hemostatic effect is 4-5 times stronger than aminoacetic acid.

Usage: po: 250mg-500mg at a time, 3 times a day;

ivgtt: 100mg-300mg at a time, no more than 600mg per day.

Aminoacetic acid

Applications: 1. Homotolytic acid; 2. Hemorrhage of cirrhosis, pulmonary bleeding, upper gastrointestinal bleeding, hemoptysis, ITP, leukemia and other bleeding; 3. Secondary hyperfibrinolysis occurs in late dic.

Pharmacology: Inhibit the activator of plasminogen, preventing plasminogen from activating plasminogen into fibrinolysin, and inhibiting the dissolution of fibrin.

Usage: 4-6g, ivgtt, 15-30min drops; maintain 1g per hour, no more than 20g per day, and can be used for 3-4 days in a row.

Ethylene diamine diacetamide (Sunni; Banglus)

Application: Prevent and treat bleeding for various causes.

Pharmacology: Inhibit plasminogen activators, promote platelet release active substances, and enhance capillary resistance.

Usage: ivgtt, 600mg-1200mg.

Aprotinase

Application: Prevent and treat bleeding and pancreatitis caused by excessive dissolution of various fibrin.

Pharmacology: Broad spectrum protease inhibitors can inhibit trypsin, chymotrypsin, plasmin and plasminogen activators.

Usage: 20,000 u/kg/d, dissolved in gs ivgtt in 2 times.

3. Thrombin

Thrombin

Applications: 1. Local hemostasis of bleeding in small blood vessels or capillaries; 2. Traumatic bleeding; 3. Oral administration is used for upper gastrointestinal bleeding.

Pharmacology: The key enzyme in the coagulation mechanism directly acts on the last step in the blood coagulation process, prompting the conversion of soluble coagulation factor i in the plasma into insoluble fibrin.

Usage: Gastroenterology hemostasis: Dissolve it in warm water into 10u-100u/ml solution for oral administration.

Prothrombin complex

Applications: 1. Bleeding caused by coagulation factor deficiency, such as hemophilia B, severe liver disease, dic; 2. Reversing bleeding induced by anticoagulant; 3. Hemophilia A, which has produced anticoagulant-induced antibodies; 4. Newborns with secondary vitamin K deficiency, oral spectroscopic antibiotics, dosing drugs in severe bleeding or preoperative preparation; 5. Sodium salt poisoning of the enemy mouse.

Pharmacology: contains coagulation factors ii, vii, ix, x and a small amount of plasma protein; ix participates in the endogenous coagulation system; vii participates in the exogenous coagulation process.

Usage: ivgtt, 1u=1ml fresh plasma.

Snake Venom Hemagglutinin (real hemostatic, Baquting)

Application: Various medical conditions that require reduced bleeding or stop bleeding.

Pharmacology: Thrombin-like action promotes platelet aggregation at the rupture of blood vessels, releases a series of coagulation factors and platelet factor 3, degradation of coagulation factors to produce fibrin i monomers, cross-linking and polymerization into insoluble fibrin, and promotes thrombosis and hemostasis at the bleeding site.

Usage: 1-2ku,po,im   or     iv.

4. Drugs to promote coagulation factor activation

Vitamin K1

Applications: 1. Vitk1 deficiency, hypocoagulant factor iiemia and oral anticoagulant overdose; 2. Neonatal hemorrhage; 3. Biliary colic; 4. Large doses are used to relieve poisoning of the rat killer "dibeninone sodium".

Pharmacology: The liver synthesizes essential substances for coagulation factors ii, vii, ix, x.

Usage: ivgtt: 10mg-50mg when stopping bleeding, repeat for 4 hours if necessary; ivgtt: 5mg/kg weight when rescuing rat poison, repeat 2-3 times, with an interval of 8-12 hours each time.

Protein sulfate

Applications: 1. Hemorrhage caused by excessive heparin injection and other spontaneous bleeding (such as hemoptysis); 2. Those who use heparin during cardiovascular surgery, extracorporeal circulation or hemodialysis, use this medicine to neutralize residual heparin in the body at the end.

Pharmacology: It is an alkaline protein that can bind with strong acidic heparin to form an inactive stable complex. This antagonism effect causes heparin to lose its anticoagulant activity.

Usage: 1. Spontaneous bleeding: 5-8 mg/kg per day, divided into two times, interval 6 hours; 2. For intravenous heparin infusion, 25-50 mg will be given after stopping the infusion; 3. After neutralizing residual heparin after extracorporeal circulation, calculate based on 1.5 mg of neutralization of 100u of heparin in this medicine; 4. For subcutaneous heparin injected heparin, calculate based on 1-1.5 mg of neutralization of 100u of heparin in this medicine, give the initial amount of 25-50 mg, diluted to 10 mg/ml, and then slowly injected intravenously within 1-3 minutes. The remaining amount is based on the expected heparin absorption time, and continue to inject 8-16 hours.

Five, blood coagulation factor

Coagulation factor

Application: Hemophilia.

Pharmacology: binds to tissue factors, activates clotting factors, stimulates the conversion of prothrombin to thrombin, and causes fibrinogen to convert to fibrin to form thrombocytosis.

Six, coagulation

Coagulation

Application: Various bleeding and stop bleeding.

Usage: 7.5mg-15mg    ,im,qd   or     bid.

7. Fibrinogen (freeze-dried human fibrinogen)

Applications: 1. Congenital fibrinogen reduction or deficiency; 2. Acquired reduction: including severe liver damage, cirrhosis, dicus, postpartum hemorrhage, etc.

Pharmacology: During the coagulation process, fibrinogen is enzymatically dissolved into fibrin by thrombin. Under the action of fibrin stabilizing factor, solid fibrin is formed and hemostatic effect is played.

Usage: 1g-2g,ivgtt.
To be continued...