Sunday, 21 May 2017

Clinically Important Drug Interactions of Fibrinolytics:




More Presentations from Naina Mohamed, PhD

©   Fibrinolytics are the medications which breakdown the fibrin inside the clot (Thrombus) but not the thrombus itself.

©   Thrombolytics are the agents, which can break down the whole thrombus (Clot) itself. Heparin acts as an indirect thrombolytic agent.

©   Anticoagulants are the drugs affecting blood coagulation factors and used to prevent harmful blood clots, which can cause serious conditions like Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), or a Stroke.

©   Anticoagulants work before the thrombus formation and they cannot dissolve the clot (Thrombus) once it is formed.

©   Hence, Fibrinolytics (Thrombolytics) are administered following a Heart attack, Stroke and Pulmonary embolism to dissolve the thrombus blocking the blood vessels.

©   Fibrinolytics include…

Ø Recombinant Tissue Plasminogen Activators (rtPA)

o  Alteplase

o  Reteplase

o  Tenecteplase

Ø Streptokinase

Ø Urokinase

©   Mechanism of action of Fibrinolytics:


©   Interaction between one or more coadministered medications leading to change in their effectiveness or toxicity, is termed as “Adverse drug interaction”.

©   It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.

©   Drugs increasing the risk of Fibrinolytics associated Bleeding include…

o  Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)

o  Antiplatelet agents (Aspirin, Clopidogrel, etc)

o  Pentosan Polysulfate Sodium


©   Herbs increasing the risk of Fibrinolytics associated Bleeding include…

o  Fenugreek

o  Garlic

o  Ginkgo

o  Evening Primrose Oil

o  Clove Oil

o  Anise

o  Turmeric (Curcumin)

o  Licorice

o  Asafetida

o  Capsicum (Capsaicin)

o  Celery

o  Kava

o  Cat's claw

o  Medowsweet

o  Feverfew

o  Tan-shen

©   Drug interactions can result in significant morbidity and mortality and thus minimizing the risk for drug interactions should be a goal in drug therapy.

©   The risk of adverse effects could be reduced by healthcare professionals through the screening, education, and follow up on suspected drug interactions.

©   Pharmacists can play a crucial role in identifying possible drug interactions by asking patients on Anticoagulants about their herbal and other alternative medicine product use.



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