Nitroglycerin
Mech: donate NO which activates guanylyl cyclase, increases dephosphorylation of myosin light chain in vascular smooth muscle causing
vasodilation
Clinical:
short acting: short term treatment of angina
long acting: angina prophylaxis, treatment of chronic
Aspirin
Mechanism of Action: Inhibition of COX-1 (irreversibly) and COX-2 (modifies activity) nonselectively. This suppresses the production of prostaglandins and thromboxanes. Prostaglandins are implicated in pain transmission, modulation of the hypothalamic the
Clopidogrel (Plavix)
Mechanism of Action: Antiplatelet agent used to inhibit blood clot formation by irreversibly inhibiting the P2Y12 receptor, which is an ADP chemoreceptor on platelet cell membranes.
Why it was indicated in case: Given to Leonardi after his MI to prevent a
Heparin
Mechanism of Action: Used to prevent DVT and PE. Heparin binds to the enzyme Antithrombin III (AT). When activated by heparin, this enzyme inactivates thrombin and other proteases involved in blood clotting (most notably Factor Xa).
Why it was indicated i
Tissue Plasminogen Activator (t-PA)
Mechanism of Action: Serine protease found in endothelial cells that is involved in the breakdown of clots. Catalyzes the conversion of plasminogen to plasmin; plasmin is the major enzyme involved in clot breakdown. T-PA is used to treat embolic or thromb
Warfarin (Coumadin)
Mechanism of Action: Does not actually "thin" the blood. Warfarin inhibits clotting indirectly via inhibition of Vitamin K epoxide reductase; this enzyme recycles oxidized Vitamin K to its reduced form. If you inhibit Vitamin K recycling, you inhibit the