Drug acting on CVS

• HEMOSTATICS - Agents that prevents hemorrhage or bleeding
• Two kinds of Hemostatic - System and Local Hemostatic
• Vitamin K (Phytomenadione) - required for the synthesis of the functional molecules g-carboxylic acid in each of the following coagulation proteins
• Coumarin anticoagulants and warfarin interfere with the role of vitamin K
• Protamine sulfate - is used to antagonize heparin-induced hemorrhages
• Thromboplastin - Local hemostatic in surgery, as spray or direct application sponge
• Thrombin - Used for bleeding from parenchymatous tissues, calcellous bone, dental sockets, laryngeal and nasal surgery
• Fibrin foam- Sponge like material prepared by action of thrombin on human fibrinogen, may be applied directly with pressure
• Absorbable gelatin sponge - This denaturized gelatin usually is soaked in bovine thrombin and left in bleeding area following closure of operative wounds
• Oxidized cellulose - Treated surgical gauze or sponge that aids coagulation in reaction between hemoglobin and cellusic acid, upon interaction with blood and tissue fluids, forms gummy matrix for clot formation
• Epinephrine and Norepinephrine - causes hemostasis by vasoconstriction.
• Anticoagulant - drugs that prevents blood clot
• Anticoagulant for laboratory examination - sodium oxalate, sodium citrate, edetate disodium, and heparin sodium
• Anticoagulants for blood transfusion - sodium citrate solution, acid citrate dextrose solution
• Heparin sodium- The only anticoagulant drug used parenterally. Endogenous heparin is present in mast cells along with histamine and serotonin.
• Heparin - prevent and treat venous thrombosis and pulmonary embolism
• Vitamin K antagonists - Warfarin and bishydrocoumarin are used as systemic anticogulants in humans.
• Hematinics - agents that improve the quality of blood by increasing the hemoglobin level and number of RBC
• Iron salts are chemically incompatible with many chemicals and drugs. Chelation type of interaction occurs between ferrous sulfate and tetracycline and limits the absorption of both compounds.
• Factors that enhance absorption of iron in the intestine are erythropoietic activity, bodily iron stores, and anemia.
• Two adverse effects of Iron - Hemosiderosis and Hemachromatosis
• Hemosiderosis - is a localized process of abnormal iron pigmentation cause by increased hemosiderin in the tissue
• Hemachromatosis - is a systemic disease of uncertain etiology, is characterized by systemic hemosiderosis accompanied by cirrhosis of the liver
• Treatment of Iron Toxicosis - Prevent absorption of iron through gastric lavage using sodium bicarbonate
• Treatment of Iron Toxicity - Systemic antidote Deferoxamine mesylate (Desferal), chelates iron
• Androgenic-anabolic steroids - Testosterone
• Testosterone - Increase formation of erytrhopoietin by the kidneys and perhaps direct acceleration of heme synthesis and red cell proliferation
• Hematinic Vitamins - Vitamin B12 and Folic Acid
• Vitamins - Essential nutrient for nuclear maturation and cell division by converting ribose nucleotide to deoxyribose nucleotides
• Deficiency of B12 and folic acid produce large short leave macrocytes since the precursor cells (megaloblast) failed to divide.
• Three Fibrinolytic Agents - streptokinase, fibrinolysin, and urokinase
• Streptokinase - Vacuum-dried powder containing streptococcal enzyme, use to activate human plasminogen to become plasmin
• Fibrinolysin - Enzyme preparation derived from a fraction of human plasma
• Urokinase - excreted in human urine, activates plasminogen and prevents serosal post-operative adhesion
• Aspirin (acetylsalicylic acid) - Acetylates COX leading to decrease production of throboxane A2 which is a vasoconstrictor and strong aggretory stimulus
• Dipyrimadole - Vasodilator with synergistic effect with ASA
• Arrhythmia - is any deviation from the normal heart rate and rhythm.
• Class II - β-adrenergic blockers.
• Class I - Membrane stabilizing drugs
• Class III - Inhibitors of Norepinephrine.