Question

Describe the pharmocological treatments detailing how the medications alter the underlying disease process (ie less focus on dosages and regimes and more focus on describing what the drug does and how that resolves the pathophysiology). If appropriate, include vaccinations (250 words). DISEASE IS DEEP VEIN THROMBOSIS

Answer 1

Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. The main Predisposing Factors for this Condition is Virchow's Triad. This Triad include-

• Venous Wall Damage - Repeated Trauma, Inflammatory process in vein, Previous Thrombophlebitis etc.
• Venous Blood Stasis- Prolonged Bed Rest, Congestive Cardiac Failure, Post-Operative Patients etc.
• Increased Viscosity(Hypercoagulability) - Trauma , polycythemia , thrombophilia, Prolonged use of OCPs etc.

Pharmacological Treatment Includes-

1. Low molecular Weight Heparin - Such as Fondaparinux,Enoxaparin etc.

As Fondaparinux is a synthetic pentasaccharide factor Xa inhibitor. Fondaparinux binds to antithrombin III and accelerates its inhibition of factor Xa. So Now As Factor Xa Won't be Activated so Factor II willl not get Converted to IIa(II activation) Thereby Fibrin Clots Are not Formed i.e Congulation Process is Halted So Thrombus will not be formed.

2. Fibrinolytic Therapy - Urokinase ,Streptokinase, recombinant tissue Plasminogen Activator(Alteplase)

The fibrinolytics act by Causing lysis to the already formed Thrombus as the Streptokinase-Plasminogen complex activates plasminogen and converts it to plasmin which in turn causes the activation of Fibrin lysis and thus produce Fibrin Degradation products.

3. Oral Anticoagulants such as- Warfarin

Warfarin decreases blood clotting by blocking an enzyme called vitamin K epoxide reductase that reactivates vitamin K_{1 .} Without sufficient active vitamin K₁, clotting factors II, VII, IX, and X have decreased clotting ability.