Pharmacology Quiz

Anticoagulants and Thrombolytics: Mechanism and Uses

• Anticoagulants prevent thrombus formation and extension, while thrombolytic drugs dissolve blood clots that have already formed in blood vessels.
• Thrombolytic drugs stimulate plasminogen activation, converting it to plasmin, which then breaks down fibrin clots into soluble derivatives.
• Types of thrombolytic drugs include non-fibrin specific (e.g., streptokinase) and fibrin specific (e.g., alteplase).
• Non-fibrin specific thrombolytics can lead to unwanted systemic fibrinolysis and increased risk of bleeding, while fibrin specific agents have a lower risk of bleeding.
• Therapeutic uses of thrombolytic drugs include acute myocardial infarction, acute ischemic stroke, and deep vein thrombosis (DVT).
• Adverse effects of thrombolytic drugs include bleeding, particularly with non-fibrin specific agents.
• Fibrinolytic inhibitors, such as aminocaproic acid and tranexamic acid, inhibit plasminogen activation and promote clot stabilization.
• Dyslipidemia, characterized by imbalances in lipid components, is a significant risk factor for cardiovascular diseases, including heart disease and stroke.
• Lipids are transported in plasma as complexes of lipid and proteins known as lipoproteins, including VLDL, LDL, and HDL.
• Commonly used lipid-lowering drugs include HMG-CoA reductase inhibitors (statins), niacin, fibrates, and bile acid–binding resins.
• Statins inhibit HMG-CoA reductase, interfering with cholesterol synthesis, and can cause myalgia, rhabdomyolysis, and increased liver enzymes as adverse effects.
• Fibrates activate nuclear receptors and regulate lipid metabolism, with adverse effects including gastrointestinal upset, diarrhea, and myositis. They also have drug interactions with warfarin and other medications.