Pharmacology for Dentistry

Coagulants and Anticoagulants 241

synthesis of coagulation factors (mainly
factor II, VII, IX and X) in liver. In synthesis
of coagulant proteins vitamins K is converted
to an epoxide which is subsequently reduced
to vitamin K. Vitamin K is metabolised in
liver and metabolites are excreted in bile and
urine.

The deficiency of vitamin K occur due
to liver disease, jaundice, malabsorption
syndromes and chronic use of antimicrobial
agents.

Adverse effects include haemolysis
especially in infants and person with G-6-
PD deficiency. Menadione can cause
jaundice, and haemolysis in infants.

Therapeutically, vitamin K is used in
prophylaxis and treatment of deficiency of
clotting factor due to dietary deficiency of
vitamin K, chronic antimicrobial therapy,
malabsorption syndrome, obstructive jaun-
dice, liver diseases such as cirrhosis and
hepatitis, in neonates to prevent or treat
haemorrhagic disease of new born; to coun-
teract the overdosing of oral anticoagulants

(phytomenadione is most effective as it acts

most rapidly).

BOTROPASE

It is a aqueous solution of haemocoagulase

isolated from venom of Bothrops jararaca and

B. atorox containing normal saline. It is

indicated in primary and secondary post-

operative internal and external haemorrhage.

ETHAMSYLATE

It inhibits prostacyclin synthetase

enzyme resulting in the prevention of

prostacyclin induced vasodilatation and

corrects abnormal platelet function. It is

mainly used to control haemorrhage in

epistaxis, haemoptysis, haematemesis,

menorrhagia and postsurgical conditions.

ADENOCHROME

MONOSEMICARBAZONE

It exerts its haemostatic action by

reducing capillary fragility, and is

indicated in epistaxis, haematuria, retinal

Table 6.1.2: Classification of coagulants.

I. Vitamin K (along with other vitamins available) 0.66 mg OD-BD

Vitamin K analogues

Menapthone (KAPLIN) 5-20 mg/day

Menadione (STYPINDON) 10-30 mg TDS

Phytomenadione 10 mg/ml IM/day

Botropase 1 ml BD-TDS IM

Ethamsylate (ALSTAT) 250-500 mg TDS

Adenochrome monosemicarbazone (STYPTOCID) 10-30 mg BD-TDS

Feracrylum (HEMOLOK) Applied locally on affected surface

Aprotinin (APROTIN) Upto 2 million KIU IV injection

II. Other

Tranexamic acid (TEXID) 15-25 mg/kg BD-QID oral, 10-15 mg/kg slow

IV TDS

Polidocanol (SCLEROL) Local application

Sodium tetradecyl (SETROL) 1-3% solution