coagulopathy

Protamine is an intravenous protein used to reverse the blood thinner heparin. This medication was initially derived from salmon sperm but is now synthesized with recombinant DNA technology. Heparin (negatively charged) forms an ionic...

P2Y12 receptor inhibitors like clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta) are powerful antiplatelet agents to promote anticoagulation in patients with acute coronary syndrome, peripheral artery disease, etc. Therefore, we often stop P2Y12 inhibitors...

Desmopressin (DDAVP, antidiuretic hormone) is a synthetic analog of vasopressin which can be administered IV, IM, subQ, and orally. Compared to vasopressin (generally regarded as a potent vasoconstrictor), DDAVP has less efficacy as a...

Disseminated intravascular coagulation (DIC) is a life-threatening condition (hence the popular alternative definition of "death is coming") affecting the coagulation cascade. Typically, clot formation and fibrinolysis are carefully balanced by various mechanisms; however, in...

NovoSeven (recombinant factor VIIa or rFVIIa) is an intravenous, structurally similar molecule to human factor VII - a protein involved in the extrinsic pathway of the coagulation cascade. This protein then activates factors IX...

Alteplase (recombinant tissue plasminogen activator, tPA) is a potent intravenous fibrinolytic (“clot buster”) used for everything from acute ischemic strokes and clearing central line ports (“Cathflo”, a total life saver!) to hemodynamically unstable pulmonary...

RiaSTAP is a fibrinogen concentrate made from pooled human plasma (may not be an option in Jehovah's Witness patients). It was FDA approved for acute bleeding in patients with congenital fibrinogen deficiency (ie, afibrinogenemia...

Tranexamic acid (“TXA”, Cyklokapron) is an analog of the amino acid lysine that works as an antifibrinolytic by binding lysine receptor sites on plasminogen to competitively inhibit its conversion to plasmin - the enzyme...