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Hemostatic compounds
General information
A number of compounds that have, or supposedly have, hemostatic activity are reviewed here. Some of them are obsolete and are included largely for historical interest. Others, such as fibrin glue, are still in use.
Aminaphtone
Experiments in the 1970s with aminaphtone (2-hydroxy-3-methyl-1,4-naphthohydroquinone-2-p-aminobenzoate) suggested that it could significantly shorten the bleeding time in both normal and heparinized rabbits and mice [ ]. Subsequent clinical experiments showed no adverse reactions and toxicological studies in animals showed no evidence of acute or long-term toxicity, even at quite high doses [ ]. No adverse reactions were noted when patients who had initially been involved in an efficacy study of limited duration were treated with aminaphtone for a further year [ ]. No data are available on the absorption or metabolism of aminaphtone in humans. It has been claimed that aminaphtone may improve symptoms related to chronic venous insufficiency as well as lymphatic stasis [ ].
Carbazochrome and carbazochrome salicylate
Adrenochrome, an oxidation product of adrenaline, is stabilized by binding to monosemicarbazone (adrenochrome monosemicarbazide). Its solubility is greatly enhanced by combination with sodium salicylate. The product, carbazochrome salicylate, can be given either by intramuscular injection or orally. The solution for intramuscular injection is hypertonic, and patients usually experience a brief stinging pain at the site of injection. Experiments in animals have shown a significant reduction in normal bleeding time when adrenochrome monosemicarbazide is given [ ]. This has been attributed to a direct effect on capillaries, as increased capillary resistance has been observed in experimental animals. Despite documentation of a transient reduction in bleeding time in humans in early experiments in the 1940s, subsequent double-blind controlled trials did not identify a useful reduction in blood loss after surgery [ ]. Despite the similarity to adrenaline, it is remarkably non-toxic and administration is not associated with the general systemic effects of sympathomimetic drugs (such as tachycardia, anxiety, or hypertension).
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