ECTURE 10课件.pptVIP

CHAPTER 40LECTURE 10 Drugs for Circulatory Disorders Circulatory Disorders Drugs used are to maintain, preserve or restore circulation Anticoagulants antiplatelets (antithrombotics), thrombolytics, antilipemics, peripheral vasodilatiors Anticoagulants - prevent formation of clots that inhibit circulation Antiplatelets - prevent platelet aggregation Thrombolytics (clot busters) - attack/dissolve formed clots Antilipemics - decrease bld. lipid concentration Peripheral vasodilators - promote dilation of vessels narrowed by vasospasm Circulatory DisordersThrombus Formation Clot is a Thrombus formed in an arterial or venous vessel thrombophlebitis - Both inflammation and clots are present Some thrombus can be superficial but it’s the DVT that’s a concern ? embolism to lungs. Circulatory Disorders Thrombus Formation Circulatory DisordersThrombus Formation Venous Formation - Usually from slow bld flow - Can occur rapidly Stagnation of the blood flow initiate the coagulation cascade? production of fibrin?enmeshes RBC’s platelets to form the thrombus. Venous thrombus has a long tail that can break off to produce an embolus. These travel to faraway sites then lodge ? in lung (capillary level) ? inadequate O2 CO2 exchange occur (ie. pulmonary embolism cerebral embolism) Oral parenteral anticoagulants (Heparin/Warfarin) primarily act by preventing venous thrombosis Antiplatelet drugs primarily act by preventing arterial thrombosis Circulatory DisordersThrombus Formation Hemostasis is the normal homeostatic process of blood clotting. Clotting proteins normally circulate in an inactive state must be activated to form a fibrin clot. When there is a trigger - inc. bld viscosity from bed rest stasis - the clotting cascade is activated. Bld vessel injured ? platelets adhering to site of injury ? release of ADP? a platelet plug - is ex. of Intrinsic clotting path. Tissue injury (outside bld vessels) = extrinsic pathway activated CirculatoryThrombus Formation C