Impact of some intravenously administered drugs (paracetamol, hydrocortisone, dexamethasone and amikacin) on coagulation hemostasis (in vitro evaluation study)

Abstract

Background: Normally, the coagulation homeostasis prevents bleeding and retain the blood in the vascular system during periods of injury. Unfortunately, pathological factors, drugs or toxins could affect one or more stages of homeostasis mechanisms leading to bleeding or abnormal thrombi. Evaluation of prothrombin time is a favorable test for the screening of extrinsic coagulation mechanism whilst activated partial thromboplastin time measurement is a global coagulation screening method for intrinsic factor. Material and Methods: Blood samples were withdrawn from healthy adults volunteers for clotting times measurements from collected plasma. The effect of paracetamol, hydrocortisone, dexamethasone, and amikacin at different concentrations on coagulation homeostasis was in vitro investigated and compared to control and positive control. Results: High concentrations of all tested drugs except amikacin prolong significantly activated partial thromboplastin time, whilst the effect on the prothrombin time was conflicting. Conclusions: Paracetamol, hydrocortisone, dexamethasone, and amikacin could prolong clotting time expressed in prolongation of activated partial thromboplastin time comparable to the anticoagulants drugs.

Artifactual prolongation of the activated partial thromboplastin time by amikacin or gentamicin with ellagic acid, but not silica activated reagent

“…Further investigation is required because there are few published reports of the prolongation of APTT by AMK and GM and clinicians are generally not aware that AMK and GM may be associated with a prolonged APTT in the absence of any coagulation disorders. 8,9 Moreover, we used only one ellagic acid APTT reagent in the in-vitro experiment and did not perform the in-vitro study on the same analyzer as the patient's sample and did not use the same ellagic acid reagent. This is a limitation because APTTs are known to react differently on the basis of their activator and phospholipid source; therefore, it is possible that the reaction may differ with another ellagic acid APTT reagent.…”