作用于血液系统的药物山东大学药理学英文课件.pptVIP

Chapter 29Agents affecting blood and hematopoietic organ Thrombosis – the formation of an unwanted clot within the blood vessls or heart Bleeding disorders –due to failure of hemostasis and include hemophilia and vitamin K deficiency Anemia -- caused by nutritional deficiency Anticoagulants Antiplatelet drugs antithrombolic drugs Fibrinolytic drugs Hemostatics Agents Used in Anemia Hematopoietic growth factors Plasma volume expanders Clot formation requires platelet activation and aggregation (white clot or platelet clot), followed by formation of a fibrin clot (red clot). §1 anticoagulants Anticoagulants are drugs employed in preventing blood coagulation. They inhibit certain clotting factors in the liver. The function of them is to: 1) prevent the formation of new blood clots. 2) keep existing blood clots from growing larger. Classification of anticoagulants ⅠAnticoagulants both in vivo and vitro: e.g. Heparin Ⅱ Anticoagulants in vivo: dicoumarol Ⅲ Anticoagulants in vitro: Sodium citrate 1. Heparin 1.1 source and chemistry pharmacokinetics Absorption Administered by i.v or s.c Metabolism Excretion 1.2 Pharmacological effects 1. Anticoagulative effect Mechanism: accelerate inactivation of clotting factors.(Ⅱa, Ⅸa, Ⅹa, Ⅺa, Ⅻa ) by enhancing the anticoagulative activity of ATⅢ ( antithrombin Ⅲ ). ATⅢ: a plasma protease inhibitor Mechanism of heparin This reaction happens in normal physiological state, but it’s very slow and weak. In the presence of heparin (which acts as an catalyst), it will be accelerated by more than 1,000 times Characteristics of anticoagulative effect 1.2 Pharmacological effects 2.Other effects adjusting blood lipid anti-inflammatory effect anti-proliferative effect on vascular smooth muscle cell inhibiting pletelet aggregation ……. 1.3 Clinical uses 1) thromboembolic disease: deep venous thrombosis(DVT), pulmonary embolism, unstable angina,