welcome! An Jie Chapter 29Agents affecting blood and hematopoietic organ Thrombosis – the formation of reaction happens in normal physiological state, but it’s very slow and weak. In the presence of heparin (which acts as an catalyst), it will be accelerated by more than 1,000 times Characteristics of anticoagulative effect effective both in vivo and in vitro quick onset and potent effects efficacy positively relative to mocular weight Pharmacological effects effects adjusting blood lipid anti-inflammatory effect anti-proliferative effect on vascular smooth muscle cell inhibiting pletelet aggregation ……. Clinical uses 1) thromboembolic disease: deep venous thrombosis(DVT), pulmonary embolism, unstable angina, acute myocardial infarction, cerebral infarction DIC (Disseminated intravascular coagulation): early stage extracorporal circulation (eg. dialysis machine) Adverse reactions Spontaneous hemorrhage : monitoring of aPTT antagonist: protamine sulfate(1mg:100u) Heparin-induced thrombocytopenia: (a decrease in circulating platelets) 2~10 days of therapy, 3% , Others : allergic reaction osteoporosis(骨质疏松) Contraindications: 1. Bleeding tendency: Severe hypertension Ulcer surgery of the brain ,eye, spinal cord 2. pregnancy 3. Renal and hepatic dysfunctions LMWHS (low molecular weight heparins) Weaker effect than heparin Low incidence of hemorrage Long-lasting effect Small individual deviation No need to monitor generally Coumarin derivatives ---Oral anticoagulants These agents are often referred to as oral anticoagulants because they are administered orally, which exists as the main difference from heparin. Warfarin(华法林), Dicoumarin(双香豆素) Acenocoumarin (醋硝香豆素) pharmacokinetics Absorption: rapid and complete (warfarin) Dist