|
CH 251, Respiratory Drugs, Skeletal Muscle Relaxants,
Antihypertensive Drugs, Angina Pectoris,
Cardiac Arrhythmias,
Congestive Heart Failure, Coagulation
Disorders and Hyperlipidia, Endocrine Pharmacology,
Male and Female Hormones,
Thyroid and Parathyroid,
Diabetes
Final Exam Objectives
COAGULATION
DISORDERS AND HYPERLIPIDIA
Coagulation prevents excess blood loss or hemorrhage.
Excessive clotting, thrombogenesis, would lead to arterial blockage.
Hyperlipidia: chronic and excessive increase in plasma lipids.
Causes cholesterol deposition in arterial walls (arteriosclerosis)
COAGULATION DISORDERS
Clot formation:
Intrinsic
Factors
Extrinsic Factors
(factors XII and XI)
tissue factor VII and thromboplastin
needs vit K
form factor Xa
with Ca2+ and platelets Xa converts
Prothrombin to Thrombin.
Thrombin converts Fribrinogen to
Fibrin which results in clot formation.
Clot Breakdown:
Tissue Plasminogen causes Profibrinolysin to form Fibrinolysin which breaks
the clot.
Overclotting: usually originates in the leg because of
sluggish blood transport. Also can
occur in patients who have been bedridden for a while (post surgery etc.)
| Treatment
|
Mechanism
|
Used
for
|
Adverse
effects (for all drugs)
|
|
Anticoagulants
Heparin
Warfarin
|
Inhibit synthesis and function of clotting
factors |
Given to patients who have been inactive for a
long time.
Heparin is given IV (it’s a large sugar molecule)
Warfarin can be given orally hence may take longer
|
Hemorrhage
Blood work should be done constantly
|
|
Antithrombotics
Aspirin
|
Inhibit function of platelets. |
Usually given for arterial occulation.(eg aspirin
inhibits synthesis of thromboxanes which prevents platelets from working) |
|
|
Thrombolytics
Streptokinase
Urokinase
|
Facilitate clot breakdown by making more
fibrinolysin |
|
|
Clotting deficiencies
| Disease |
Cause |
Treatment |
Adverse
effects |
|
Hemophilia |
Hereditary disease
Lack of clotting factors:
Hemophilia A: factor VIII and
Hemophilia B: factor IX
|
Replacing factors from human blood |
Infections from blood |
|
Deficiency
of Vit K |
Deficiency from diet or lack of intestinal
bacteria |
Administration of vit K |
|
|
Antifibrinolytics |
Excessive bleeding after surgery because of
overactive fibrinolytic activity |
Antifibrinolytics eg aminocaproic acid |
|
Rehabilitation Concerns:
-
watch
for open wounds
-
avoid
rigorous exercises
-
keep
aspirin handy
HYPERLIPIDIA
High concentration of lipids in blood.
Cause is usually poor diet and lifestyle.
Sometimes can be genetic.
HDL: high density lipoproteins (good)
LDL: low density lipoproteins (bad)
| Treatment
|
Mechanism
|
Adverse
effects for all
|
|
HMG-CoA
inhibitors eg Zocor, Mevacor |
(3-hydroxy-3-methylglutarylcoenzymeA) reductase
catalyzes cholesterol formation. The
HMG-CoA inhibitors prevent this enzyme from working |
Nausea, diarrhea are common but usually well
tolerated. |
|
Fibric
acids eg Lopid |
These lower triglyceride levels by increasing
breakdown of LDL |
|
|
Others
eg Niacin |
decreases LDL synthesis |
|
Rehabilitation Concerns:
Help
out with a diet plan for hyperlipidia
|