Phosphodiesterase inhibitors, fibronolytics, prothrombotics

Peripheral arterial occlusive disease

Intermittent claudication (↓↓ O2 delivery)

• Inhibit interplatelet binding

• Inhibit aggregation

MOA of glycoprotein IIb/IIIa inhibitor

• Tirofiban

• Eptifibatide

• Abciximab

Glycoprotein IIb/IIIa inhibitor

Streptokinase

From streptococcus pyogenes

• 2-year interval between doses

• Antihistamine

• Consider APSAC

What to do if there is allergy in streptokinase

Alteplase and reteplase

Recombinant human - tPA

Tenecteplace

Mutant tPA

• Facial assymetry

• Arm weakness

• Slurring of speech

• Time

Signs if ischemic stroke

0.9mg/kg t-PA bolus then 10% as infusion for 1 hr.

Dose of t-PA during the golden period of ischemic stroke

3 hours

Golden time for ischemic stroke in the Philippines

Relative contraindication for t-PA

• Pregnancy

• MI

K₁ and K₂

Natural vitamin K

K₃

Synthetic vitamin K

Phytomenadione

K₁

Menaquinone

K₂

Menadione

K₃

Aminocaproic acid analogue

Tranexamic acid

Destroys t-PA

MOA of tranexamic acid

VIII and IX

In hemophilia, a patient is low in what clotting factor

Serine protease inhibitor

Aprotinin

Aprotinin attacks plasmin

MOA of aprotinin