Bleeding & Clotting

How the body reacts to bleeding

Bleeding or bruising is a sign that a blood vessel has been damaged. When this happens, the body reacts immediately to begin forming a plug, or blood clot, to repair the damage.

  • The clot is made up of platelets—blood cell fragments that stick together at the injury site—and fibrin, a repair protein that holds the platelets together. 1,2
    • This clotting process is also called hemostasis.

Hemostasis and the role of VWF

Hemostasis is a 2-stage process that requires the presence and collaboration of many different clotting factors. One of the most important is von Willebrand factor (VWF)—a glue-like protein that plays a critical role in both the primary (1) and secondary (2) stages of hemostasis3,4:

  1. During primary hemostasis, VWF helps build the clot by binding platelets together at the injury site1
  2. During secondary hemostasis, VWF helps stabilize the clot by binding and circulating with factor VIII and protecting it from clearance. VWF concentrates FVIII at the injury and helps to generate fibrin1,4

Successful completion of primary and secondary hemostasis usually results in the formation of a stable hemostatic plug. However, when there is not enough VWF in the blood, or the VWF does not function properly, clots might not form effectively.3,4

References:

  1. National Heart, Lung, and Blood Institute. The Diagnosis, Evaluation, and Management of von Willebrand Disease. Bethesda, MD: National Institutes of Health; 2007. NIH Publication No. 08-5832.
  2. National Hemophilia Foundation. What is a bleeding disorder? http://www.hemophilia.org/NHFWeb/MainPgs/ MainNHF.aspx?menuid=26&contentid=5&rptname=bleeding. Accessed September 23, 2011.
  3. National Hemophilia Foundation. What is von Willebrand disease? http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid= 182&contentid=47&rptname=bleeding. Accessed September 23, 2011.
  4. Kleinert D, Orto C, Gioia K, Hannan M. Von Willebrand Disease: a nursing perspective. J Obstet Gynecol Neonatal Nurs. 1997;26:271-276.

Important Safety Information

Stimate® (desmopressin acetate) Nasal Spray, 1.5 mg/mL is a treatment used to stop some types of bleeding in people with mild hemophilia A or mild to moderate von Willebrand disease (VWD) Type 1. Stimate Nasal Spray should not be used in children under 11 months of age.

All patients using Stimate Nasal Spray are at risk of water intoxication, fluid overload and low sodium levels in the blood. Follow your healthcare provider’s instructions on limiting the amount of fluid you drink when using Stimate Nasal Spray, as too much fluid intake can lead to serious adverse reactions, including seizures, coma, and even death. Fluid restrictions are especially important for children and elderly patients, as they are at higher risk for these reactions.

See the patient information leaflet in the prescribing information for Stimate Nasal Spray for symptoms that could mean your blood sodium level is low—including headache, hallucinations, confusion, restlessness, weight gain and muscle spasms. Immediately report any of these symptoms to your physician or, if necessary, an emergency department. Also contact your doctor immediately if you have uncontrolled bleeding.

Before being prescribed Stimate Nasal Spray, make sure your doctor knows about all your medical conditions and about any medications you are taking. Use Stimate Nasal Spray exactly as your healthcare provider has instructed.

Side effects of Stimate Nasal Spray generally come from having too much water in the body. The most common include facial flushing, nasal congestion, runny nose, nose bleed, sore throat, cough, and upper respiratory infections. Tell your healthcare provider if you experience a side effect that does not go away.

Please see full prescribing information for Stimate Nasal Spray

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.