Coagulants are agents that promote clotting, used in conditions where there is a deficiency or dysfunction in the clotting cascade.
Vitamin K:
Mechanism: Essential for γ-carboxylation of certain glutamate residues in clotting factors II, VII, IX, and X, as well as proteins C and S.
Use: Vitamin K deficiency, warfarin reversal, hemorrhagic disease of the newborn.
Side Effects: Generally safe; hypervitaminosis K is rare.
Prothrombin Complex Concentrates (PCC):
Mechanism: Provide concentrated clotting factors II, VII, IX, and X.
Use: Urgent reversal of warfarin anticoagulation, warfarin-induced bleeding.
Side Effects: Thrombosis risk, allergic reactions.
Fresh Frozen Plasma (FFP):
Mechanism: Contains all coagulation factors.
Use: Multiple factor deficiencies, liver disease, massive transfusion protocols.
Side Effects: Transfusion-related acute lung injury (TRALI), allergic reactions, volume overload.
Desmopressin (DDAVP):
Mechanism: Releases von Willebrand factor and factor VIII from endothelial cells.
Use: von Willebrand disease, mild hemophilia A.
Side Effects: Hyponatremia, fluid retention.