COAGULATION CASCADE es er tne rer rn) on gn LLY etree “rane penter J vn poe x tla want cousin naan zz, + x1 ——_> a J ee ssn Facey ——h feta Vt compton > X ——*— xa face ap acer > Pret Facer® D> rhombin acorn) 3X 5 rete Thrombin cre ingen rin toinogen factor), ——A proviCOAGULATION INHIBITION (Anticoagulant pathwa 4 Coagulation Cascade is started Protein C and Protein S J “Inacvat Fector a od Va “Inhibit eoogulation cascade from spreading and keeps it atthe site of injury roteln Se a cofactor for Proteln © ° ° ww Thrombin dla) rennin Thrombomodulin ‘#1000 FLow - Protine Present on sil of morma vsclr al threushbied ———P © we frroteing— binds 'othvombin and incest vessel ° oo M ve Teen 6) Trembameduin tomb complex 00. os vita activates Protein € Thrombin. vine Tissue Factor Pathway Inhibitor w inhibits Tse Fctor-Vlla complex Thrombin a) Inhibit Faetor Xa Blood Clot formation Fibrin formed from the coagulation cascade cross-links ‘Antithrombin te form amesh ind Thrombin (Factor ls) and Factor x8 tivated platelets get caught in the mesh and clot i formed Inhibits the spread of congulstion t Heparin Enoxaparin (Lovenox*), Daltaparin (Fragmin®), tinzaparin (Innohep*) Fondaparinux (Arixte ‘These drags stimulate antithrombin ‘Antithrombin inhibits Factor Xa and tla (thrombin) except Jn the caso of fondaparinux which only leads to Factor Xa inhibitionPlatelet activation nae Fong mood on wean fatr ) a Ogg OO stoop fiow ——p > oo peat oN UL e—T:SCCSS A ‘reach in blood vessel wall Patlets come in contact with collagen beneath vessel wall Beedemaseate eli ctor ‘von Webra factor (WA ie actuated auting platelet adhesion ‘ton boodvocsusl tovecalwon ‘tycooroten ta Trance ht cues atbeon rnapenonstyi ‘Tissue Factor (also called Factor il and thromboplastin) \ Coagulation cascade tect ater GP Db/ila inhibitors ‘china oho) ‘puna gen x Teron ison) ans a tanta taertsy 9% (COX INHIBITORS ‘Arachidonic acid (4A)> x Thon sini tenets 8) Other NSAIDS A oantantagoiat Verepanar onto] x| eon 2% ‘Thrombowane 82 (12), 00 (adenosine aphasia) “Thromboxane A2 Pavia Receptor ‘akon ltd by ADP cane tele aeration \ Diertamel ern gp avu2 mvatrroRs coe patna nastrons This causes an increase in local concenvations of adenosine dendogel ivi) ‘response to ADP and other activators. oe * Aa is converted by COX to DA2 in platelets ‘is converted by COX? 10 protacyen i endothelial ‘esailationin endothe and smooth muscle cls COK-Lihibon hibits thombost wile COR? nhbigon promotes thrembos era iia “Aemete pices loge nth mesh and ot formed ‘1004 clot dahated plates get coun