Heparin

MOA: binds irreversibly to the endogenous antithrombin III through a key pentasaccride
accelerating the action of antithrombin III by 1000 folds leading to increased inactivation
of factor X and factor III

Clinical uses
o
Quick reversal of thrombosis
o
Venous thrombosis
o
Pulmonary embolism
o
Acute coronary syndromes

Limiations
o
Bind similtanously to fibrin and thrombin increasing the amount of thrombin
bound fibrin
o
Binds to plasma proteins

unpredicatable dose response
o
Rebound ischemia
o
Need to monitor PPT and aPPT
o
Heparin induced thrombocytopenia
Nitroglycerine relieves angina by
1.
Venodilation; decreasing the preload and thereby decreasing the workload on the heart
2.
Vasodilation of coronary vessels increase the blood supply to the myocardium
3.
Inhibit platet aggregation decreasing ischemic damge
When ST segment elevation is confiremed by ECG, immediate revascularizations is indicated,
since there is no PCI or CAAG, tthrombolytics is
good choise

Source link