Drugs That Alter Blood Clotting Fantastic Voyage The

Drugs That Alter Blood Clotting Fantastic Voyage

The importance of regulated clotting hemophilia VS Slide. Share Nethealth. Book. com

The importance of regulated clotting hemophilia VS Slide. Share gandhiji 40

The importance of regulated clotting southof 64. com

Background: platelets and clotting The Merck Manuals

Background: platelets and clotting

The importance of proteases https: //www. youtube. com/watch? v=FNVv. Q 788 wzk

Value of a cascade? Ken Miller, Brown University WWW. Britannica. com

Value of a cascade? Ø Amplification Ø Regulation Ken Miller, Brown University WWW. Britannica. com

Key terms Ø clotting factor Ø zymogen (proenzyme)

What would you target to inhibit clotting?

1. Inhibition of clotting factors a) Warfarin Ø Some clotting factors (prothrombin, X, VII, IX) contain several g-carboxyglutamic acid groups.

Importance of gamma carboxylic acid Ø The g-carboxyglutamic acid groups are important for interacting with phospholipid on activated platelets and damaged endothelium. https: //www. studyblue. com/notes/note/n/vpath-final/deck/6443882

Warfarin Ø Warfarin inhibits the formation of g-carboxyglutamic acid groups on clotting factors.

Warfarin – inhibition of Vitamin K regeneration

b) Other inhibitors of clotting cascade Ø Rivaroxaban (Xarelta) – binds to and inhibits factor Xa

2. Exploitation of restorative pathways a. Anti-thrombin Ø Anti-thrombin is a natural inhibitor of several clotting factors including thrombin. Ø It inhibits the clotting factor by directly binding to it. Biochemistry for Medics, N. Chhabra

Exploitation of restorative pathways a. Anti-thrombin Ø Heparin can increase the rate of clotting factor inhibition 1000 -1, 000 fold. Biochemistry for Medics, N. Chhabra

Heparin Ø Q: How would this drug be administered?

Questions for consideration: 1. Why are patients who require an immediate anti-clotting treatment often initially given heparin rather than warfarin? 2. What is an advantage of switching patients from heparin to warfarin as a long-term anti-clotting drug?

b. Tissue plasminogen activator (t. PA) Ø Converts fibrin-bound plasminogen to plasmin Ø Plasmin is a protease that then degrades the clot

Why would an ER physician may want to do some type of brain scan prior to administering t. PA to a stroke patient?

3. Back to the platelet- Inhibitors of platelet activation 123 RF. com

The activated platelet Food and Public Health 2015, 5(1): 1 -9

stimulus Vascular and Endovascular Surgery Volume 40, Number 4, 2006

Activation of fibrinogen binding Current Medicinal Chemistry, 2004, Vol. 11, No. 17 2247

The activated platelet Food and Public Health 2015, 5(1): 1 -9

ADP Vascular and Endovascular Surgery Volume 40, Number 4, 2006

ADP receptor inhibition Clopidogrel (Plavix) ADP

Inhibition of COX 1 Food and Public Health 2015, 5(1): 1 -9

Inhibition of COX 1 by aspirin Food and Public Health 2015, 5(1): 1 -9

Why so complicated? Key points?

Drug List for entire course Ø Ø Ø Warfarin Heparin Clopidogrel Aspirin Tissue plasminogen activator (t. PA)