• Executive Summary (an introduction/background to the case study) The clotting cascade is essential in the human body to allow for healing of a broken artery or vein. If we don’t have these clotting factors or clotting cascade it can lead to serious consequences such causing bleeding out eventually leading to death as shown in haemophilia. The clotting cascade consists of primary and secondary haemostasis. Primary haemostasis being the formation vasoconstriction and platelet aggregation at the site of injury and secondary haemostasis being the formation of a clot. In more detail, it starts off with binding of tissue factor VIIa which initiates the coagulation cascade and formation of factor X (thrombin) and eventually fibrin. Platelets …show more content…
Angiolillo, D. et.al, 2007). The drug prevents platelet degranulation and release which expands prothrombic and inflammatory mediators while also inhibiting the transformation of GP IIb/IIIa receptor that forms fibrinogen (J. Angiolillo, D. et.al, 2007). Figure 3. This figure shows the mechanism of action of Clopidogrel (Guzman, F. 2008). Clopidogrel inhibits aggregation for 7 to 10 days which is the average lifespan of a platelet, it produces a dosage dependent effect which begin 2 hours after a single dose and the inhibition is approximately 40% to 60% in adults (L. Buck, M. and D, P., 2010). • Pharmacokinetic Implications ( a description of the mechanism of the patient response) Clopidogrel is taken orally and is rapidly absorbed having a bioavailability of 50% (L. Buck, M. and D, P. 2010). Food doesn’t affect its absorption so it is able to be consumed with or without food (Drugs.com. …show more content…
The metabolic pathway being mediated by the CYP2C19, CYP3A, CYP2B6 and CYP1A2 enzymes. The maximum concentration with a single dose of 300mg loading dose is twice as high as it is after four days of 75mg maintenance dose which occurs approximately 30 to 60 minutes after dosing. Figure 4. This figure shows metabolic activation of Clopidogrel. Bioavailability is determined by intestinal absorption. 85% converted too inactive metabolites via esterase’s and 15% converted to active thiol-containing metabolite by CYP450 enzymes (Agewall et al., 2013). Conversion to 2-oxo-cloipidogrel is catalysed by CYP2C19, CYP1A2 and CYP2B6 while the second step is catalysed by CYP3A4, CYP2B6, CYP2C19, and CYP2C9 which form the active metabolite and binding to the P2Y12 receptors inhibiting ADP-induced platelet activation (Agewall et al., 2013). After 5 days Drugs.com (n.d.) stated that there was 50% excreted in urine with 46% in faeces with a half-life of approximately 6 hours. Clopidogrel being metabolized by CYP2C19 and using other inhibitors of this enzyme results in reduced plasma concentrations (Drugs.com.
In Blood In Blood Out is a drama directed by Taylor Hackford, and starring Damian Chapa (Miklo), Benjamin Bratt (Paco), and Jesse Borrego (Cruz), produced by Hollywood Pictures. The film was based off everyday life in East Los Angeles, from the 1970’s through the 1980’s. Damian Chapa stars as Miklo in the film, a Mexican-American who wanted to be accepted, not by his skin but for the Mexican within him. Benjamin Bratt (Paco) was the older cousin of Miklo, who learned his lesson throughout the movie and changed his ways. Jesse Borrego (Cruz) is the step-brother of Paco who was a talent artist, who ended up turning to drugs because of back problems caused by a rival gang incident.
Coumadin works by inhibiting with how your body uses vitamin K. The metabolism of Coumadin, vitamin K and vitamin K dependant clotting factors take place in your liver. “Coumadin prevents the production of the vitamin K dependent clotting factors and this results in a slower clotting rate.” (National Blood Clot Alliance, 2014)
In some individuals with severe hemophilia, the factor VIII replacement therapy is identified as a foreign substance by their immune system. If this happens, their immune system will make 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.
Viagra is taken orally. It is quickly absorbed into the system and usually reaches its peak concentration in about 30 to 120 minutes. However, as with most orally administered drugs, taking the pill on a full stomach will slow down its absorption (Sildenafil Citrate, par. 5). Viagra is metabolized in the liver by the cytochrome p450 system. It is converted into a metabolite that has properties similar to that of the pre-metabolized drug. Viagra and its metabolite have a "terminal half-life of about 4 hours" (Sildenafil Citrate, par. 4). Finally, Viagra is excreted primarily through feces in the form of metabolites (Sildenafil Citrate, par. 7).
COX-1: Cox-1 is responsible to protect the lining of the stomach and to regulate blood platelets. It also decreases fever and regulates blood platelets promoting blood clotting. NSAIDS and aspirin can be used for inhibition of Cox-1 for the desirable effect of decreasing platelets aggregation, but it can also decrease the protection of stomach lining. As a result, it can cause bleeding and
Pharmacokinetics provides a basis to assess the course of drugs and their effects on the body (Dhillon & Kostrzewski, 2006). The processes of pharmacokinetics can be broken down into the absorption, distribution, biotransformation, and excretion in, through, and out of the body. These are major concepts that guide medication use and dosage selection (Association of Surgical Technologists, 2017).
-Wong, D. T., Bymaster, F. P., Horng, J. S., & Molloy, B. B. (1975). A new selective inhibitor
...-1 (PAI-1) from the endothelial cells and monocytes, activating the extrinsic coagulation pathway. This also leads to activation of factor X and fibrin production.
“Pharmacokinetics (PK) and pharmacodynamics (PD) can be seen as two sides of the same coin. PK and PD have a definite relationship, assessing how much drug gets to the site of action and then what that action is. Both activities are essential in the complete investigation of the interaction between the drug and body, and play significant roles in both drug development and their continual use in the clinical setting (Institute Of Clinical Research, Clinical Pharmacology Special Interest Group, Pharmacokinetics vs. Pharmacodynamics).”
...his test examines the medication via in vitro analysis to induce or inhibit CYP1A2, CYP2B6 or CYP3A4 in fresh cultured human hepatocytes by evaluating catalytic activity3.
The liver plays central role in each of these phases of clotting process, as it synthesizes the majority of coagulation factors and proteins involved in fibrinolysis as well as thrombopoietin., which is responsible for platelet production from megakaryocytes. In cirrhosis, liver is badly get damaged. So the production of coagulation factors and proteins is impaired. Many pathological processes associated with cirrhosis, such as portal hypertension and endothelial dysfunction as well as co-morbid conditions, may also alter the coagulation process. Consequently, patients with liver disease as in cirrhosis, have a disturbed balance of procoagulant and anti- coagulant factors which deviates from the normal coagulation cascade.
...nt for inhibitors, over the past century or so have improved the treatment of hemophilia and have helped saved many lives.
While on that drip, it should have been tested even more frequently to keep check on the dextrose's effects. Yet, several hours would go by without it being tested, at all. I don't know the exact number of times it was usually tested each day because I was very sick and was not keeping track of it. Although, I shouldn't have had to worry about that, since I was in the hospital. I think it was only tested four to six times per day, if even that much.
The five parameters of Liberation Absorption, Distribution, Metabolism and Excretion (LADME for short) are responsible for the changes in concentration of a drug in the body, theory stands that the magnitude of the response requires, and depends on, the concentration of the drug in the fluid the is bathing the target tissue. A deep understanding of these processes is vital in order to provide the correct chemical therapy for a patient. Liberation is the release of the drug from its dosage form and the active ingredient is liberated, for example, the breakdown of capsules in the stomach or mouth. Absorption is the process that involves the movement of the administered compound from the entry site to the bloodstream.
platelets on a slide, you would need to have the specimen recollected because of a clot, or