Key Difference – Anticoagulants vs Thrombolytics
抗凝剂是用于防止不当形成的药物血块inside the循环系统whereas thrombolytics are the drugs used for the removal of thrombi that occlude the vessels, causing various diseases such as缺血性heart diseases and中风。抗凝剂和溶栓剂之间的主要区别在于anticoagulants are used to prevent the formation of new blood clots in the circulatory system, while thrombolytics are used to remove the blood clots that have been already formed inside the blood vessels.
内容
1.Overview and Key Difference
2.什么是抗凝剂
3.什么是溶栓剂
4.抗凝剂和溶栓剂之间的相似之处
5。Side by Side Comparison – Anticoagulants vs Thrombolytics in Tabular Form
6。概括
什么是抗凝剂?
血凝块是纤维蛋白纤维在各个方向运行并夹住血细胞的网状工作,platelets和plasma。凝结是一种生理机制,是由于血管破裂或对血液本身损害而启动的。这些刺激激活了一系列化学物质,形成一种称为凝血酶原活化剂的物质。然后,凝血酶原激活剂催化凝血酶原转化为凝血酶。最后,充当酶的凝血酶催化了纤维蛋白纤维的形成fibrinogen这些纤维蛋白纤维彼此纠缠在一起,形成了我们称之为凝块的纤维蛋白网。
如前所述,形成凝血酶原激活剂需要一系列化学物质的激活。这种特殊的化学物质激活可以通过两种主要途径发生。
- 内在途径- 当患有血液创伤时,这是激活的固有途径
- 外部途径– extrinsic pathway gets activated when the traumatized vascular wall or the extravascular tissues come into contact with the blood.
人类血管系统采用多种策略来防止在正常情况下血管系统中血凝块的形成。
- 内皮表面因素 - 内皮表面的平滑度有助于防止内在途径的接触激活。内皮上有一层糖卵形涂层,可排除凝血因子和血小板,从而防止了凝块的形成。血栓统治的存在,这是内皮上发现的一种化学物质,有助于对抗凝血机制。血小板蛋白与凝血酶结合并停止纤维蛋白原的激活。
- The anti-thrombin action of fibrin and antithrombin iii.
- 动作heparin
- 血凝块溶解纤溶酶原
很明显,从这些对策human body doesn’t want to have any blood clots inside it under the normal conditions. But evading these protective mechanisms blood clots can be formed inside our body. Conditions like trauma,atherosclerosis, and infection can roughen the endothelial surface, activating the clotting pathway. Any pathology that leads to the narrowing of a blood vessel also has a tendency to form clots because the narrowing of the vessel slows down the blood flow through it and consequently more procoagulants are accumulated at the site making a favorable environment for the formation of blood clots.
抗凝剂的基本药理学
抗凝剂是用于防止循环系统内血凝块不当形成的药物。根据这些药物的作用机理,它们分为不同的子类别。
间接凝血酶抑制剂
这些药物被称为间接凝血酶抑制剂,因为它们对凝血酶的抑制作用是通过与另一种称为抗凝结蛋白的蛋白质相互作用而发生的。未分流的肝素(UFH)和Low Molecular Weight Heparin (LMWH)结合抗凝血酶增强其XA因子失活。
肝素
Antithrombin inhibits the action of clotting factors IIa, IXa, and Xa by forming stable complexes with them. In the absence of heparin, these reactions occur slowly. Heparin acts as a cofactor for anti-thrombin increasing the rate of the relevant reactions by at least 1000 folds. Unfractioned heparin markedly inhibits blood clotting by inhibiting all three factors including thrombin and factor Xa. But the anticoagulant effect of low molecular weight heparin is lesser than that of UFH due to its low affinity towards antithrombin. Enoxaparin, dalteparin, and tinzaparin are some examples for LMWH.
密切监测接受UFH的患者的血液凝结机制非常重要。这是通过通常每月评估患者的APTT来完成的。另一方面,由于其可预测的药代动力学和血浆水平,因此在LMWH下的患者不需要这种监测。
不利影响
- 甚至是轻微的创伤后出血过多
- 肝素诱导的血小板减少症
Contraindications
- 对药物的高敏性
- 主动出血
- 颅内出血
- 严重的高血压
- Active TB
- 明显的血小板减少症
- 先兆流产
The excessive anticoagulant effect of heparin can be corrected by discontinuing the drug. If the bleeding persists the administration of protamine sulfate is indicated.
华法林
华法林is a commonly used anticoagulant with a 100% of bioavailability. Majority of the warfarin administered into the human body is bound to plasma albumin giving it a small volume of distribution and a long half-life.
华法林防止凝血酶原,凝血因子VII,IX和X的谷氨酸残基的羧化。这使这些分子不活跃损害了凝结机制。由于前面提到的辅助因子已经存在羧化分子,华法林的作用延迟了8-12小时,其作用掩盖了华法林的作用。
不利影响
- 华法林可以通过胎盘屏障,导致胎儿出血性疾病
- 它也可能导致胎儿的骨骼变形。
Other than these frequently used anticoagulation agents, oral direct factor Xa inhibitors such as rivaroxaban and parental direct thrombin inhibitors are also used to control coagulation.
什么是溶栓剂?
溶栓剂are the drugs used for the removal of thrombi that occlude the vessels causing various diseases such as ischemic heart diseases and stroke.
The early use of thrombolytics in the management of ischemic heart diseases is proven to be effective in reducing the size of the thrombus and in increasing the patency of the vessel.
所有溶栓剂都通过将纤溶酶原激活为纤溶酶发挥作用,从而导致血栓和止血纤维蛋白塞中纤维蛋白的降解。This markedly increases the risk of intracranial hemorrhages.
Streptokinase
链霉菌酶是由β-溶聚糖产生的酶streptococci。它形成纤溶酶原的复合物,然后将纤溶酶原裂解成纤溶酶。由于链霉菌酶是人体的一种异物,因此有些患者可以对其产生过敏反应。由于各种疾病疾病而需要溶栓且对链霉菌酶过敏的患者应清楚地表明他们倾向于对链霉菌酶产生过敏的趋势。
高度倍数
重组高度酶是由内源性纤维蛋白水解酶开发的,其释放会触发纤维蛋白溶解。尽管高度酶比链霉菌酶具有更快的溶栓效应,但它具有引起颅内出血的高风险。另一方面,这种药物比其他溶栓剂更昂贵。
What is the Similarity Between Anticoagulants and Thrombolytics?
- 两组药物均用于控制凝结。
What is the Difference Between Anticoagulants and Thrombolytics?
抗凝剂与血栓溶液 |
|
抗凝剂是用于防止循环系统内血凝块不当形成的药物。 | 溶栓剂是用于去除血栓的药物,该药物阻塞血管并引起各种疾病,例如缺血性心脏病和中风。 |
利用 | |
These are used in preventing the formation of blood clots inside the vessels. | 这些用于去除已经形成的血液凝块。 |
行动 | |
They act by inactivating various components of the clotting cascade. | 所有溶栓剂都通过将纤溶酶原激活为纤溶酶发挥作用,从而导致血栓和止血纤维蛋白塞中纤维蛋白的降解。 |
不利影响 | |
肝素的不良影响
Adverse effects of warfarin
|
可能会对链霉菌酶产生过敏反应。 颅内出血are a fatal complication of thrombolytics. |
Contraindications | |
肝素的禁忌症是
|
如果患者对其过敏,则禁忌使用链球菌酶。 |
摘要 - 抗凝剂与溶栓剂
抗凝剂是用于防止循环系统内血凝块不当形成的药物。溶栓剂are the drugs used for the removal of thrombi that occlude the vessels causing various diseases such as ischemic heart diseases and stroke. While anticoagulants are used to prevent the formation of blood clots, thrombolytics are used to remove the blood clots already formed inside the vessels occluding them. This is the major difference between these two groups of drugs.
下载PDF版本的抗凝剂与Throlbolytics
You can download PDF version of this article and use it for offline purposes as per citation notes. Please download PDF version here溶栓和抗凝剂之间的差异
参考:
1. Katzung,B。G.,Masters,S。B.和Trevor,A。J.(2012)。基础和临床药理学。纽约:麦格劳 - 希尔医学。
2. Reid,J。L.,Rubin,P。C.,&Whiting,B。(2001)。关于临床药理学的讲义。牛津:布莱克威尔科学。
Image Courtesy:
1. “Warfarintablets5-3-1” By Gonegonegone at English Wikipedia – Own work(CC BY-SA 3.0)viaCommons Wikimedia
2.芭芭拉(WVS)的“凝块预防流程图” - 通过Commons Wikimedia
发表评论