In a healthy human being, the body is able to prevent excessive bleeding. This prevention occurs through the action of plasma and this specific action causes the plasma to become sticky and form clots. Clots are composed at the place where the injury occurs to stop excessive bleeding due to possible wounds in the area and potentially causing death. Clotting takes place naturally and it relies on many chemical reactions occurring in the body so a substance called thrombin can be produced. However blood clots can also form abnormally and this is not common in a healthy person. When blood clots, without the need of it to then this can cause a heart attack or a stroke. Most heart attacks occur due to the formation of a blood clot on the cholesterol plaque inside an artery in the heart or even the brain. When the plaque bursts, thrombogenic substances are exposed to blood which therefore triggers the blood clotting mechanism (WebMD). This is where the use of anticoagulants comes in. Anticoagulants are medicines that reduce blood clotting in an artery, a vein or the heart. They can also prevent existing clots from getting bigger as this would prevent any further blockages. There are many different types of anticoagulants but the three main ones that I am going to explore in this report are Warfarin, Enoxaparin and Apixaban.
Warfarin is the main anticoagulant used in the UK and it works by intervening with the production of vitamin K. This essential vitamin is used in the clotting process and it works by acting on the proteins that form part of the clotting process in your body. Warfarin has a narrow therapeutic window so a lot of dosages of warfarin are needed and this makes dosing problematic. So usually half a milligram at a time is g...
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...ring pregnancy and delivery. Apixaban should be used during pregnancy only if the benefits outweighs the risks to the mother and unborn baby. So some anticoagulants can be used during pregnancy but there is always a risk and should be monitored by a doctor. To conclude, as Warfarin has high solubility and permeability the formulation that would be best suited can be in tablet form as it would be absorbed well. However Enoxaparin has high solubility and low permeability and it’s a hydrophilic molecule so if it was given in tablet form it would not be absorb in the gut. It would be administered by subcutaneous injection for the high bioavailability. And finally Apixaban can be absorbed well in the gut but this is restricted by the dosage of the drug due to its poor solubility and the preferred administration route of this drug would also be by intravenous injection.
Cardiovascular agents are used to treat the heart, circulatory, and vascular system. Each Sub-Class has a unique active ingredient that targets the issues that our body cannot fight with alone. Patients who have one or more cardiovascular conditions such as CHF, hypertension and an arrhythmia may be taking multiple medications for each condition. There are multiple subclasses that I will be discussing. Even though they all are used for the cardiovascular system, they do target different areas.
...ould reconstitute to the final concentration of 100mg/ml first, then solution must be further dilute into 1mg/ml or 2mg/ml by adding 5ml of the original solution to 500ml or 250ml of normal saline or other compatible solution. It should be administer over 3 hours for 1mg/ml or over 1 hour for 2mg/ml for intermittent administration, and for oral form, it should be one hour before or two hours after meal. Beside that, a key thing to educate patient and family are to minimize direct sunlight during treatment, can only take magnesium or aluminum 2 hours before or after taking this drugs. On the other hand, when giving azithromycin to patient, the nurse should monitor for loose stool or diarrhea, monitor closely for PT and INR with concurrent use of warfarin, and especially report any sign and symptom of hypersensitivity because it can be serious even though it is rare.
Many factors can increase the risk of these clots, including prolonged bed rest (such as after surgery), sitting for long periods (such as on a plane), use of birth control pills or hormone replacement therapy, pregnancy, family history of DVT, inflammatory bowel disease, and certain genetic clotting disorders. Compression stockings are also sometimes used in people who have an acute DVT, to prevent a group of symptoms known as post-thrombotic syndrome that includes leg pain and
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
(14) Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD.. (2009). Dabigatran versus warfarin in patients with atrial fibrillation.. New England Journal Of Medicine. 361 (12), 1139-51.
If this happens, their immune system will develop antibodies against factor VIII. These antibodies will inhibit the ability of the factor to work in the clotting process. The higher the antibody or inhibitor level, the more factor VIII replacement therapy it takes to overcome the inhibition and produce clotting. This can complicate the treatment of a bleed. The good news is that there are different types of therapies available to successfully treat most individuals who develop inhibitors.
...lood Vessel Stents.” 1-3). Bypass surgery is another option; a blood vessel from somewhere in the body is used to go around the blocked artery. This completely bypasses the blocked artery, so it no longer becomes an issue. Thrombolytic therapy is a method that involves injecting a medication into the artery that will dissolve the clot and allow blood to pass freely through the artery (“Peripheral Artery Disease.” 3).
The next stage in myocardial infarction is the formation of thrombus. Exposure of the subendothelial matrix of the plaque to blood due to superficial abrasion generates platelet activation and aggregation. Clotting factors on the platelet membrane carry out reaction which release prothrombin activator, this activator then converts prothrombin to enzyme thrombin. The transformation of fibrinogen to fibrin is then catalysed by thrombin. During proteolysis (the breaks down of protein), fibrinogen is converted to fibrin strands which stabilize the final blood clot. Complete occlusion of coronary artery by thrombus disrupts blood flow and causes ischemia due to atherosclerotic coronary artery steno...
Hemophilia is a rare bleeding disorder that slows the blood clotting process, which is not normal. Some people with Hemophilia may just have a little bit of “clotting factor” or no clotting factor at all (National Institute of Health [NIH], 2013). Clotting factor is a protein in blood that controls bleeding and they are needed the blood to clot normally. In order to help the blood clot, clotting factors work with “platelets” (National Institute of Health [NIH], 2013). Platelets are small blood cell fragments that form in the bone marrow, a tissue in the bones that is similar to a sponge. The functions of platelets have a very important role in blood clotting; the role of a platelet is to stick together (by the help of clotting factors) to block cuts, break on the carriers of blood (veins or arteries) throughout the body, and stop the bleeding when “blood vessels” (National Institutes of Health [NIH], 2013) are injured. Blood vessels are tube like structures carrying blood through the tissues and organs, like a vein, artery, or capillary. People with hemophilia do not have enough “clotting factor VIII or IX” (World Federation of Hemophilia [WFH], 2013) in their blood, which results to prolonged bleeding or oozing, meaning that bleeding can last longer (though, not faster) than usual after surgeries, accidents, or having teeth pulled out at the dentist. Clotting factor VIII, which can also be called as “anti-hemophilic factor” (AHF, for short) (Patient.co.uk, 2011), is a blood clotting protein that is necessary for humans to have. Clotting Factor IX is a protein that i...
In septic patients, increased levels of PAI-1 inhibit plasminogen activator (t-PA), which converts plasminogen to plasmin. Release of fibrin inhibits fibrinolysis by activation of thrombin-activatable fibrinolysis inhibitor (TAFI). In addition, the release of PAF causes platelet aggregation. This combination of inhibition of fibrinolysis, fibrin strand production and platelet aggregation contribute to a state of coagulopathy. This can lead to microcirculatory dysfunction with isolated or multiple organ dysfunction and cell death. Mr Hertz’s coagulation profile showed a fibrinogen level of 5.6 g/L, indicating that coagulopathies were underway in his system.
The Cost to Come of Age How grave must a situation be for one to mature in their perspectives, or in other words, come of age? Evan Hunter’s On the Sidewalk Bleeding explores the idea of psychological growth through the seriousness of death. The protagonist Andy, transitions from ignorance to knowledge, idealism to realism, and thinking of self to thinking of others throughout the story.
Two medical procedures that can be done for a heart attack are a Coronary angioplasty and stenting. This procedure is when the doctor insert a long catheter that passes through an artery to a blocked artery in the heart, its usually through the leg or groin. This procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. The catheter is equipped with a special balloon that , once in position, is briefly inflated to open a block coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term and restore blood flow to the heart. The doctor may opt to place a stent coated with a slow releasing medication to help keep the artery open, depending on the condition of the
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
Desmopressin is a common treatment used by women to stop extensive bleeding during their period and also can be used before a small surgery it comes in an injection form or nasal spray, which causes a stimulation of blood vessels to release von Willebrand factor protein; which in like part (d) giving a person this treatment will allow them to clot faster and not bleed out just because of a small procedure for example, done by the dentist. (Mayo). Another treatment is replacement therapies, which are infusions of blood-clotting factors found in von Willebrand factor the only way these will be advised to be used is when Desmopressin does not work. (Mayo). Contraceptives can also be used as a treatment because they are used for excessive bleeding during periods of women. There are different forms of contraceptives like pills, injections and progesterone (Mayo). Anti-fibrinolytic contain aminocaproic acid and tranexamic acid allows for clots to stay in place once they have attached to the blood vessel wall (Mayo). Fibrin sealants are used to patch up areas where a minor cut has occurred to stop the ongoing bleeding. These treatments are all used to come up with the same final product which is to clot blood and stimulate the production of von Willebrand
... you should take baby aspirin (81 mg). The earlier a patient takes preventative measures the less a patient has to worry about taking other medication such Warfarin which have many adverse side effects such as excessive bleeding. Patients need to continuously check legs for any signs and symptoms of DVT.