HEMATOLOGICAL DISORDERS

Structure & Function of Blood Components

✅ Definition:
Blood is a specialized connective tissue that transports oxygen, nutrients, hormones, and waste products throughout the body. It consists of plasma (55%) and formed elements (45%).

✅ Composition of Blood:

Component	Percentage	Function
Plasma	55% of blood volume	Carries nutrients, hormones, waste, & clotting factors.
Red Blood Cells (RBCs, Erythrocytes)	40-45% (Hematocrit)	Oxygen transport (via Hemoglobin).
White Blood Cells (WBCs, Leukocytes)	<1%	Immune defense & infection control.
Platelets (Thrombocytes)	<1%	Blood clotting & wound healing.

✅ Blood Functions:

• Oxygen & Carbon Dioxide Transport (via RBCs & Hemoglobin).
• Immunity & Defense (via WBCs).
• Clotting & Coagulation (via Platelets & Clotting Factors).
• Nutrient & Waste Transport (via Plasma).
• Hormone Distribution (via Plasma).
• Temperature Regulation (via Blood Circulation).

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2. Assessment of Blood Function & Disorders

✅ Definition:
Assessment involves clinical history, physical examination, and laboratory tests to evaluate blood-related disorders (Anemia, Leukemia, Clotting disorders, etc.).

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2.1. History Taking in Hematological Assessment

✅ Key Questions to Ask the Patient:

1. Symptoms of Blood Disorders

Symptom	Possible Cause
Fatigue, Weakness, Pallor	Anemia (Iron Deficiency, B12 Deficiency, Aplastic Anemia).
Frequent Infections	Leukopenia, Leukemia, Immunodeficiency.
Easy Bruising, Excess Bleeding	Thrombocytopenia, Hemophilia, Vitamin K Deficiency.
Jaundice (Yellow Skin, Eyes)	Hemolytic Anemia, Liver Disease.
Swollen Lymph Nodes	Lymphoma, Leukemia, Infections.
Bone Pain	Multiple Myeloma, Leukemia.
Shortness of Breath, Dizziness	Severe Anemia, Blood Loss.

2. Past Medical History

• History of Blood Disorders (Anemia, Clotting Disorders, Leukemia).
• Previous Blood Transfusions.
• Chronic Diseases (Diabetes, Kidney Disease, Cancer).

3. Family History

• Genetic Blood Disorders (Sickle Cell Disease, Thalassemia, Hemophilia).

4. Medication & Lifestyle History

• Use of Blood Thinners (Warfarin, Heparin).
• Alcohol & Smoking History (Affects Bone Marrow Function).
• Diet (Iron, Vitamin B12, Folate Deficiency).

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2.2. Physical Examination in Blood Disorders

✅ Step-by-Step Examination:

1. General Inspection

• Pallor (Anemia).
• Jaundice (Hemolysis, Liver Disease).
• Fatigue, Weight Loss (Leukemia, Cancer).

2. Skin & Mucous Membrane Examination

Finding	Possible Cause
Petechiae (Small Red Spots)	Thrombocytopenia, Leukemia.
Ecchymosis (Large Bruises)	Bleeding Disorders (Hemophilia, Platelet Dysfunction).
Pale Skin & Nail Beds	Anemia.
Glossitis (Smooth, Swollen Tongue)	Vitamin B12 or Iron Deficiency.

3. Lymph Node Examination

Enlarged Lymph Nodes	Possible Cause
Painless, Firm Nodes	Lymphoma.
Tender, Mobile Nodes	Infection.
Hard, Fixed Nodes	Metastatic Cancer.

4. Abdominal Examination

Finding	Possible Cause
Splenomegaly (Enlarged Spleen)	Leukemia, Sickle Cell Disease.
Hepatomegaly (Enlarged Liver)	Liver Disease, Hemolysis.

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3. Diagnostic Tests for Blood Disorders

✅ Definition:
Blood tests help detect, confirm, and classify hematological diseases.

✅ Common Hematological Diagnostic Tests:

3.1. Complete Blood Count (CBC)

✅ Purpose:

• Evaluates RBCs, WBCs, Hemoglobin, Platelets.

Parameter	Normal Range	Significance
Hemoglobin (Hb)	Men: 13-17 g/dL, Women: 12-15 g/dL	↓ Anemia, ↑ Polycythemia.
Hematocrit (Hct)	Men: 40-54%, Women: 36-48%	↓ Anemia, ↑ Dehydration.
RBC Count	Men: 4.7-6.1 million/µL, Women: 4.2-5.4 million/µL	↓ Anemia, ↑ Polycythemia.
WBC Count	4,000-11,000/µL	↓ Leukopenia, ↑ Infection, Leukemia.
Platelet Count	150,000-450,000/µL	↓ Thrombocytopenia, ↑ Thrombocytosis.

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3.2. Peripheral Blood Smear

✅ Purpose:

• Examines blood cell shape & abnormalities under a microscope.

✅ Findings:

Finding	Condition
Sickle Cells	Sickle Cell Anemia.
Howell-Jolly Bodies	Post-Splenectomy.
Hypersegmented Neutrophils	Vitamin B12 Deficiency.
Schistocytes (Fragmented RBCs)	Hemolysis, DIC.

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3.3. Bone Marrow Aspiration & Biopsy

✅ Purpose:

• Evaluates bone marrow function & blood cell production.
• Used for Leukemia, Aplastic Anemia, Multiple Myeloma Diagnosis.

✅ Findings:

Finding	Condition
Hypercellular Marrow	Leukemia.
Hypocellular Marrow	Aplastic Anemia.
Plasma Cell Overgrowth	Multiple Myeloma.

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3.4. Coagulation Tests

✅ Purpose:

• Evaluates blood clotting disorders (Hemophilia, DIC, Liver Disease).

Test	Purpose	Normal Value	Clinical Significance
Prothrombin Time (PT)	Measures Extrinsic Pathway	11-13 sec	↑ in Warfarin Use, Liver Disease.
Activated Partial Thromboplastin Time (APTT)	Measures Intrinsic Pathway	30-40 sec	↑ in Hemophilia, Heparin Use.
International Normalized Ratio (INR)	Monitors Warfarin Therapy	1.0 (Normal), 2-3 (On Warfarin)	↑ Risk of Bleeding if High.
Fibrinogen Level	Clot Formation	200-400 mg/dL	↓ in DIC.

Anemia

✅ Definition:
Anemia is a condition where the hemoglobin (Hb) level is lower than normal, reducing oxygen transport capacity in the blood.

✅ Normal Hemoglobin (Hb) Levels:

Gender	Normal Range
Men	13-17 g/dL
Women	12-15 g/dL

✅ Types & Causes of Anemia:

Type	Cause	Key Features
Iron Deficiency Anemia	Chronic blood loss, Poor diet	Microcytic (Small), Hypochromic (Pale) RBCs
Vitamin B12 Deficiency (Pernicious Anemia)	Lack of intrinsic factor, Poor diet	Megaloblastic (Large) RBCs, Glossitis, Neuropathy
Folic Acid Deficiency	Poor diet, Pregnancy	Megaloblastic anemia (No neuropathy unlike B12 deficiency).
Aplastic Anemia	Bone marrow failure, Drugs, Radiation	Pancytopenia (↓ RBCs, WBCs, Platelets), Bone marrow suppression.
Hemolytic Anemia	Sickle Cell, G6PD Deficiency	Jaundice, Dark urine, Reticulocytosis (↑ Young RBCs).

✅ Symptoms of Anemia:

• Fatigue, Weakness, Pallor.
• Shortness of breath, Dizziness.
• Cold hands & feet, Tachycardia.

✅ Diagnosis of Anemia:

Test	Findings
CBC (Complete Blood Count)	↓ Hb, ↓ Hematocrit, ↓ RBC count.
Peripheral Smear	Shows abnormal RBC morphology.
Serum Ferritin & Iron Levels	↓ in Iron Deficiency.
Vitamin B12 & Folate Levels	↓ in Megaloblastic Anemia.

✅ Management of Anemia:

Type	Treatment
Iron Deficiency Anemia	Iron supplements (Ferrous sulfate).
Vitamin B12 Deficiency	B12 injections or oral B12.
Folic Acid Deficiency	Folic acid supplements.
Aplastic Anemia	Bone marrow transplant, Immunosuppressants.
Hemolytic Anemia	Blood transfusion, Corticosteroids.

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2. Thalassemia

✅ Definition:
Thalassemia is a genetic disorder causing defective hemoglobin production, leading to microcytic anemia.

✅ Types of Thalassemia:

Type	Cause	Severity
Alpha Thalassemia	Mutation in alpha-globin gene.	Mild to severe (Hydrops fetalis is fatal).
Beta Thalassemia (Cooley’s Anemia)	Mutation in beta-globin gene.	Mild (Minor) or Severe (Major).

✅ Symptoms of Thalassemia Major:

• Severe Anemia (Hb <7 g/dL).
• Jaundice, Dark Urine.
• Hepatosplenomegaly (Enlarged Liver & Spleen).
• Bone Deformities (Frontal bossing).

✅ Diagnosis:

Test	Findings
CBC & Peripheral Smear	Microcytic, Hypochromic RBCs.
Hemoglobin Electrophoresis	Identifies abnormal hemoglobin (HbF ↑ in Beta Thalassemia).
Genetic Testing	Confirms mutation.

✅ Management of Thalassemia Major:

• Regular Blood Transfusions (Prevent severe anemia).
• Iron Chelation Therapy (Deferasirox, Deferoxamine).
• Bone Marrow Transplant (Curative in severe cases).

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3. Polycythemia

✅ Definition:
Polycythemia is a condition where RBC count is abnormally high, increasing blood viscosity.

✅ Types of Polycythemia:

Type	Cause	Key Features
Primary Polycythemia (Polycythemia Vera – PV)	Bone marrow disorder (JAK2 mutation).	↑ RBCs, WBCs, Platelets, Risk of Clots.
Secondary Polycythemia	Chronic hypoxia (COPD, High altitude), EPO-secreting tumors.	Only RBCs ↑, Normal WBCs & Platelets.

✅ Symptoms of Polycythemia:

• Ruddy complexion, Headaches, Dizziness.
• Increased clot risk (Stroke, DVT).

✅ Diagnosis & Management:

Test	Findings
CBC	↑ RBCs, ↑ Hematocrit, Normal/↑ WBCs & Platelets.
Serum EPO (Erythropoietin)	↓ in Polycythemia Vera, ↑ in Secondary Polycythemia.

✅ Treatment:

• Phlebotomy (Bloodletting).
• Hydroxyurea (For Polycythemia Vera).
• Treat underlying cause in secondary polycythemia.

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4. Leukopenia & Neutropenia

✅ Definition:

• Leukopenia: Low WBC count (<4,000/μL).
• Neutropenia: Low neutrophil count (<1,500/μL), increasing infection risk.

✅ Causes:

• Bone marrow suppression (Chemotherapy, Radiation).
• Viral infections (HIV, Hepatitis, COVID-19).
• Autoimmune diseases (Lupus, Rheumatoid arthritis).

✅ Symptoms:

• Frequent infections (Fever, Sore throat, Skin infections).

✅ Management:

• G-CSF (Filgrastim) to stimulate WBC production.
• Antibiotics for infection prevention.

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5. Leukocytosis & Leukemia

✅ Definition:

• Leukocytosis: High WBC count (>11,000/μL), usually due to infection or inflammation.
• Leukemia: Cancer of WBCs, leading to uncontrolled growth in bone marrow.

✅ Types of Leukemia:

Type	Common in	Key Feature
Acute Lymphocytic Leukemia (ALL)	Children	Blast cells in blood.
Chronic Lymphocytic Leukemia (CLL)	Elderly	Smudge cells.
Acute Myeloid Leukemia (AML)	Adults	Auer rods in myeloblasts.
Chronic Myeloid Leukemia (CML)	Middle-aged adults	Philadelphia chromosome (BCR-ABL).

✅ Symptoms of Leukemia:

• Fatigue, Frequent infections, Easy bruising.
• Bone pain, Night sweats, Weight loss.

✅ Diagnosis & Treatment:

Test	Findings
CBC & Peripheral Smear	Blast cells, High WBC count.
Bone Marrow Biopsy	Confirms leukemia type.

✅ Treatment:

• Chemotherapy, Targeted Therapy (Imatinib for CML).
• Bone Marrow Transplant (For Severe Cases).

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6. Lymphomas (Hodgkin & Non-Hodgkin)

✅ Definition:
Lymphoma is cancer of lymphocytes (WBCs in lymph nodes).

✅ Types:

Type	Key Feature
Hodgkin Lymphoma (HL)	Reed-Sternberg Cells (Owl Eyes).
Non-Hodgkin Lymphoma (NHL)	More aggressive, No Reed-Sternberg Cells.

✅ Symptoms:

• Painless, Enlarged Lymph Nodes.
• Night Sweats, Fever, Weight Loss (B Symptoms).

✅ Treatment:

• Chemotherapy, Radiation Therapy.

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7. Multiple Myeloma

✅ Definition:
Multiple myeloma is a cancer of plasma cells in the bone marrow.

✅ Symptoms (CRAB Features):

• Calcium ↑ (Hypercalcemia).
• Renal Failure.
• Anemia.
• Bone Pain (Fractures).

✅ Diagnosis:

• Bence Jones Proteins in Urine.
• M-Spike on Electrophoresis.

✅ Treatment:

• Chemotherapy, Bone Marrow Transplant.

Bleeding Disorders Overview

✅ Definition:
Bleeding disorders are conditions where the blood does not clot properly, leading to excessive or prolonged bleeding. These disorders can be due to platelet abnormalities (Thrombocytopenia, Purpura), clotting factor deficiencies (Hemophilia), or acquired conditions (Liver Disease, DIC, Vitamin K Deficiency).

✅ Types of Bleeding Disorders:

Category	Examples	Cause
Platelet Disorders	Thrombocytopenia, ITP (Idiopathic Thrombocytopenic Purpura)	↓ Platelet count or function.
Clotting Factor Deficiencies	Hemophilia A & B, Von Willebrand Disease	Inherited lack of clotting factors.
Acquired Coagulation Disorders	Liver Disease, DIC, Vitamin K Deficiency	Liver failure, Infections, Trauma.

✅ Common Symptoms of Bleeding Disorders:

• Excessive bruising, Easy bleeding.
• Nosebleeds (Epistaxis), Gum bleeding.
• Heavy menstrual bleeding (Menorrhagia).
• Prolonged bleeding after injuries or surgeries.
• Petechiae (Small red spots on the skin) in platelet disorders.

✅ Diagnostic Tests for Bleeding Disorders:

Test	Purpose	Normal Value	Clinical Significance
Platelet Count	Assesses platelet function.	150,000-450,000/µL	↓ in Thrombocytopenia.
Prothrombin Time (PT)	Assesses Extrinsic Pathway.	11-13 sec	↑ in Liver Disease, Warfarin use.
Activated Partial Thromboplastin Time (APTT)	Assesses Intrinsic Pathway.	30-40 sec	↑ in Hemophilia, Heparin therapy.
Bleeding Time (BT)	Measures platelet function.	2-7 min	↑ in Platelet Disorders.
Fibrinogen Level	Assesses clot formation.	200-400 mg/dL	↓ in DIC.
D-Dimer Test	Detects clot breakdown.	Negative (<0.5 mg/L)	↑ in DIC, Pulmonary Embolism.

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2. Thrombocytopenia

✅ Definition:
Thrombocytopenia is a platelet disorder where platelet count falls below 150,000/µL, increasing the risk of bleeding.

✅ Causes of Thrombocytopenia:

Category	Causes
Decreased Platelet Production	Aplastic anemia, Leukemia, Chemotherapy.
Increased Platelet Destruction	Idiopathic Thrombocytopenic Purpura (ITP), DIC, Heparin-induced thrombocytopenia (HIT).
Splenic Sequestration	Liver Cirrhosis, Hypersplenism.

✅ Symptoms of Thrombocytopenia:

• Petechiae (Small red skin spots).
• Purpura (Large purple skin patches).
• Gum bleeding, Prolonged bleeding after minor cuts.

✅ Management of Thrombocytopenia:

Type	Treatment
Mild (50,000-100,000/µL)	Monitor, Treat underlying cause.
Severe (<20,000/µL, Spontaneous Bleeding)	Platelet Transfusion, Corticosteroids (For ITP).
Immune-Mediated (ITP, HIT)	IV Immunoglobulin (IVIG), Splenectomy (Severe Cases).

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3. Purpura & Hemophilia

3.1. Purpura

✅ Definition:
Purpura is a condition where blood leaks from small vessels into the skin, leading to purple-colored patches.

✅ Types of Purpura:

Type	Cause
Non-Thrombocytopenic Purpura	Vasculitis (Henoch-Schönlein Purpura, Scurvy).
Thrombocytopenic Purpura	Low platelet count (ITP, DIC).

✅ Symptoms:

• Non-blanching purple spots.
• Mild cases: No serious bleeding.

✅ Management:

• Corticosteroids (For ITP).
• Plasmapheresis (For TTP – Thrombotic Thrombocytopenic Purpura).

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3.2. Hemophilia

✅ Definition:
Hemophilia is an inherited bleeding disorder caused by a deficiency of clotting factors.

✅ Types of Hemophilia:

Type	Deficient Factor	Inheritance
Hemophilia A	Factor VIII	X-linked Recessive.
Hemophilia B (Christmas Disease)	Factor IX	X-linked Recessive.
Von Willebrand Disease	Von Willebrand Factor (vWF)	Autosomal Dominant.

✅ Symptoms of Hemophilia:

• Spontaneous Joint Bleeding (Hemarthrosis).
• Excessive bleeding after minor trauma.
• Intracranial hemorrhage (Severe cases).

✅ Diagnosis of Hemophilia:

Test	Findings
APTT	↑ in Hemophilia A & B.
Factor VIII & IX Levels	↓ in respective hemophilia types.

✅ Management of Hemophilia:

• Factor VIII (For Hemophilia A), Factor IX (For Hemophilia B) Replacement Therapy.
• Desmopressin (For Mild Hemophilia A).
• Avoid NSAIDs & Aspirin (Increase bleeding risk).

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4. Acquired Coagulation Disorders

4.1. Liver Disease & Coagulation Disorders

✅ Why Does Liver Disease Cause Bleeding?

• The liver produces most clotting factors.
• Liver failure leads to ↓ clotting factors → ↑ Bleeding Risk.

✅ Diagnosis:

Test	Findings
PT & INR	Prolonged in Liver Disease.
Fibrinogen Level	↓ in Severe Liver Disease.

✅ Management of Liver Disease Coagulopathy:

• Fresh Frozen Plasma (FFP) for Severe Bleeding.
• Vitamin K (For Deficiency).

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4.2. Vitamin K Deficiency

✅ Definition:
Vitamin K is essential for synthesis of clotting factors II, VII, IX, X.

✅ Causes of Vitamin K Deficiency:

• Liver Disease (Impaired Absorption).
• Long-Term Antibiotic Use (Destroys Gut Flora Producing Vitamin K).
• Newborns (Low Vitamin K at Birth → Risk of Hemorrhagic Disease of Newborn).

✅ Diagnosis & Treatment:

• ↑ PT/INR (First Test to Be Affected).
• Vitamin K Injection (For Deficiency).

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4.3. Disseminated Intravascular Coagulation (DIC)

✅ Definition:
DIC is a life-threatening condition where excessive clotting and bleeding occur simultaneously due to widespread clotting factor depletion.

✅ Causes of DIC:

Cause	Example
Sepsis (Most Common).	Gram-negative bacterial infections.
Trauma & Surgery.	Burns, Massive hemorrhage.
Obstetric Complications.	Amniotic Fluid Embolism, Placental Abruption.

✅ Symptoms of DIC:

• Uncontrolled Bleeding (IV sites, Mucosa, Organs).
• Multi-Organ Failure (Kidney, Liver, Brain).

✅ Diagnosis:

Test	Findings
PT, APTT, INR	Prolonged.
Platelet Count	↓ Thrombocytopenia.
D-Dimer	↑ High (Excessive clot breakdown).

✅ Management of DIC:

• Treat the underlying cause (Antibiotics for Sepsis, Surgery for Trauma).
• FFP & Cryoprecipitate for Clotting Factor Replacement.
• Heparin (Only in Early Stage to Prevent Clot Formation).

Cardiovascular Drugs

✅ Definition:
Cardiovascular drugs are medications used to treat heart diseases, hypertension, arrhythmias, heart failure, and clotting disorders.

✅ Classification of Cardiovascular Drugs:

Category	Examples	Indications
Antihypertensives	ACE Inhibitors, Beta-Blockers, Diuretics	Hypertension, Heart Failure.
Antiarrhythmics	Amiodarone, Lidocaine, Adenosine	Arrhythmias.
Heart Failure Medications	Digoxin, ACE Inhibitors, Diuretics	Congestive Heart Failure.
Antianginal Drugs	Nitroglycerin, Beta-Blockers	Angina, Ischemic Heart Disease.
Antiplatelets & Anticoagulants	Aspirin, Clopidogrel, Heparin, Warfarin	Prevent Blood Clots (DVT, Stroke, MI).
Thrombolytics	Alteplase (tPA), Streptokinase	Dissolve Clots in Stroke, MI.

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1.1. Antihypertensive Drugs

✅ Definition:
Antihypertensive drugs lower high blood pressure and prevent complications like stroke, heart attack, and heart failure.

✅ Types of Antihypertensives:

Class	Examples	Mechanism	Side Effects
ACE Inhibitors	Ramipril, Enalapril, Lisinopril	↓ BP by relaxing blood vessels	Cough, Hyperkalemia, Angioedema.
Angiotensin II Receptor Blockers (ARBs)	Losartan, Valsartan	Blocks Angiotensin II → Vasodilation	No cough (Preferred over ACE inhibitors).
Beta-Blockers	Metoprolol, Propranolol, Atenolol	↓ HR & BP, ↓ Myocardial Oxygen Demand	Bradycardia, Fatigue, Bronchospasm.
Calcium Channel Blockers	Amlodipine, Nifedipine, Verapamil	Vasodilation, ↓ BP	Swelling, Flushing, Headache.
Diuretics	Furosemide, Hydrochlorothiazide, Spironolactone	Remove excess fluid, ↓ BP	Dehydration, Hypokalemia (Furosemide).

✅ Key Points:

• ACE Inhibitors are first-line for Hypertension & Heart Failure.
• Beta-Blockers are contraindicated in asthma & COPD (cause bronchospasm).
• Calcium Channel Blockers are effective in elderly patients.
• Diuretics are best for volume overload & edema.

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1.2. Antiarrhythmic Drugs

✅ Definition:
Antiarrhythmic drugs treat abnormal heart rhythms by controlling heart rate and rhythm.

✅ Classification of Antiarrhythmic Drugs (Vaughan Williams Classification):

Class	Examples	Indication
Class I (Sodium Channel Blockers)	Lidocaine, Quinidine	Ventricular Arrhythmias.
Class II (Beta-Blockers)	Metoprolol, Esmolol	Atrial Fibrillation, SVT.
Class III (Potassium Channel Blockers)	Amiodarone, Sotalol	Life-threatening Arrhythmias.
Class IV (Calcium Channel Blockers)	Verapamil, Diltiazem	Atrial Fibrillation.
Adenosine	Used for SVT	Rapid IV push for supraventricular tachycardia (SVT).

✅ Key Points:

• Amiodarone is used in life-threatening arrhythmias but causes thyroid & lung toxicity.
• Adenosine stops the heart for a few seconds (used for SVT).

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1.3. Heart Failure Drugs

✅ Definition:
These drugs improve heart function and prevent fluid overload.

✅ Commonly Used Drugs:

Class	Examples	Mechanism
Cardiac Glycosides	Digoxin	↑ Heart contraction, ↓ HR.
Diuretics	Furosemide, Spironolactone	Removes excess fluid.
ACE Inhibitors	Enalapril, Lisinopril	↓ Afterload, improves survival.
Beta-Blockers	Carvedilol, Metoprolol	↓ Heart workload.

✅ Key Points:

• Digoxin toxicity → Nausea, Bradycardia, Yellow Vision.
• Diuretics cause dehydration & electrolyte imbalances.

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2. Circulatory Drugs

✅ Definition:
Circulatory drugs prevent or dissolve blood clots and improve blood flow.

✅ Types of Circulatory Drugs:

Class	Examples	Indications
Antiplatelet Agents	Aspirin, Clopidogrel, Ticagrelor	Prevent MI, Stroke, CAD.
Anticoagulants	Heparin, Warfarin, DOACs (Apixaban, Rivaroxaban)	DVT, PE, Atrial Fibrillation.
Thrombolytics	Alteplase (tPA), Streptokinase	Acute MI, Stroke.

✅ Key Points:

• Aspirin & Clopidogrel prevent platelet aggregation in heart disease.
• Warfarin requires INR monitoring (Target: 2-3).
• Thrombolytics are used in emergency stroke & MI cases.

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3. Hematology Drugs

✅ Definition:
Hematology drugs treat anemia, blood disorders, and clotting abnormalities.

✅ Common Drugs in Hematology:

Class	Examples	Indications
Iron Supplements	Ferrous Sulfate, Ferric Carboxymaltose (IV Iron)	Iron Deficiency Anemia.
Vitamin B12 & Folic Acid	Cyanocobalamin, Folic Acid	Megaloblastic Anemia.
Erythropoietin (EPO)	Epoetin Alfa, Darbepoetin	Anemia in Chronic Kidney Disease (CKD).
Granulocyte Colony-Stimulating Factor (G-CSF)	Filgrastim, Pegfilgrastim	Neutropenia.
Clotting Factor Replacement	Factor VIII, Factor IX	Hemophilia A & B.

✅ Key Points:

• Iron supplements cause constipation & black stools.
• Vitamin B12 is given IM in pernicious anemia.
• Erythropoietin is used in CKD patients to prevent anemia.
• G-CSF stimulates WBC production in chemotherapy-induced neutropenia.

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4. Drugs for Bleeding Disorders

✅ Definition:
These drugs help in clot formation and prevent excessive bleeding.

✅ Common Drugs for Bleeding Disorders:

Class	Examples	Indications
Clotting Factor Replacement	Factor VIII (Hemophilia A), Factor IX (Hemophilia B)	Hemophilia.
Vitamin K (Phytonadione)	Corrects Warfarin overdose, Vitamin K deficiency.
Desmopressin (DDAVP)	Von Willebrand Disease, Hemophilia A.
Antifibrinolytics	Tranexamic Acid, Aminocaproic Acid	Excessive bleeding (Dental, Surgery, Menorrhagia).

✅ Key Points:

• Vitamin K reverses Warfarin overdose.
• Desmopressin (DDAVP) boosts Factor VIII & vWF levels.
• Tranexamic Acid prevents excessive bleeding in surgery & trauma.