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HEMOSTASIS-PRIMARY HEMOSTASIS (PLT AGGREGATION)

Haematology

HEMOSTASIS-PRIMARY HEMOSTASIS (PLT AGGREGATION)

1. After endothelial injury, platelets rapidly attach to the newly exposed subendothelial collagen.

2. The von Willebrand factor, released from the endothelium, reacts with the platelet surface glycoprotein Ib/IX to increase "stickiness" of platelets to each other and to exposed collagen.

3. Platelets are then activated, releasing cytokines, including ADP and arachidonic acid, which further stimulate platelet release and aggregation.

4. Fibrinogen then cross-connects the IIb/IIIa protein on platelets to form platelet plugs.

5. Drugs: NSAIDs bind reversibly with cyclooxygenase; Clopidogrel irreversibly inhibits ADP binding to the platelet receptor, resulting in decreased platelet aggregation.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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