Ch 7 Histamine

H1 receptors Cause allergic ↑Ca musle Betaiastindralagwe

contractin , ebsng merve udingpain , itching'
Lhistantnoth
) Vaso dilate ,Pumeability ↑ vertigo
暈 ,

H2 receptors Cause gastric acid secretion ↑cAMP {

frear aloer
t peptic
H1 blocker allergic Moa: compete h1 sites, use: allergic, sedative, nausea, cold. Side: dry mouth, hypotension, urine
,

Asthmn 3

考,
retention. Nonsedating: (-dine) Desloratadine, Fexofenadine, Loratadine/ (-tadine) ↑ Appetite 不熟
H2 blocker GI Cause: reduce gastric secretion. Use: peptic ulcer gastritis, reflux esophagitis (Ranitidine most preferred)
Rokatilin loug auting )→ preahesthetic
Gastvic ↓
-

(-tidine) Rauitidne ,
Famotidine LPo feut 了 ,
Epotems ,

Ch8 Eicosanoids ProstaglandinsEPas

)
轮
Misoprostol Peptic ulcer associated with NSAID use

⇌
Dinoprostone Contraction of the uterus

Ch9 NSAIDs Non-steroidal anti-inflammatory drug

⇌
NSAIDs is inhibitor of cox-1 and cox-2 then PG (2: inflammation site, pain, fever). Use: analgesics, antipyretics, anti-
⼼所 UOSa Pzote七 K
o ⼼ PrelyWLhi { ☆ ol<

inflammation/ Paracetamol, Metamizol: analgesics, antipyretics, poor anti-inflammatory

,他ed纷

more cox-1 inhibitor (homeostasic) nonselective inhibitor more cox-2 inhibitor

ketorolac naproxen piroxicam

sorevessibly
.

Asprin (antiplatelet, antitherombotic) tolmetin diclofenac

flurbiprofen ibuprofen 做友好的

celecoxib

ketoprofen fenoprofen meloxicam

indomethacin etodolac

￡
Side effect (low done Aspirin irreversibly inhibit platelet TXA2 and COX-1) →
→

e
∞
”晶的
GI mucosa cox1 inhibition Kidney cox1 and 2 inhibitions Cardiovascular cox1 and 2 inhibitions

Peptic ulcers Na & water retention Stroke

GI bleeding Hypertension ↑ Myocardial infarction

Hemodynamic acute, kidney injury

Use wifind reat G红 Bublem

GI disturbances: prevention: NSAIDs after food/ misoprostol, H2 blockers, with NSAIDs/ used selective COX2 inhibitors
P@
20 % ⼼
celecoxi) .

Hypersensitivity: avoid aspirin, NSAIDs patient with asthma, nasal polyps, recurrent rhinitis and urticaria
ww …
…

( coxibs
-
)
Use Salicylate interferes vitamin K in liver, Reye’s syndrome (in child under 18)
…

Pregnancy: inhibit PG synthesis, increase postpartum hemorrhage

Clinical used of NSAIDs

• analgesic: painful conditions

• π
antipyretic: paracetamol isprefered➔inhibitPGsynthesiswithinCNScox3

• Rheumatoid arthritis: first choice, do not alter progression of disease

• Acute rheumatic fever: Aspirin is the preferred drug.

• Osteoarthritis: mild: paracetamol/ sever: NSAID

TXA2 (irreversibly)
• Thromboembolic disorders: low dose aspirin inhibit cox-1cause bleed➔ treatment of thromboembolic disorders (aspirin
⼆⽀
cause anticoagulation) a. transient ischemic attacks b. myocardial infarction

celecoxib Ecoxib }
=
az 友好
ianalges
selective cox-2 inhibitors/ gastric friendly/ but: kidney toxic and increase cardiovascular disease
=

paracetamol Antipyretic/ analgesic/ use with ibuprofen (for patient with peptic ulcer, asthma, child, pregnancy)

IX anti -

indlammatery
.
 Ch 10 opioid
M
morphine strong agonists, strong mu agonist, another variable partial agonist

sfl
CNS: t
出铋
ti 機 0
'

不好
depressant effects: analgesic, euphoria, sedation, respiratory depression, 止 cough, hypothermia
consmutpupils
Stimulant effects: miosis, nausea, vomiting, bradycardia ↓

Other: Physical and psychological dependence 依賴, Histamine release

e.
,
CVS: vasodilation, hypotension

GIT: constipation/ urinary retention/ bronchospasm

Side: Drug dependence (withdrawal symptoms), leads to cross tolerance, respiratory depression
→ 酒精戒斷
Treat drug dependence: buprenorphine, naltrexone twnpg
( Antagonist)

hydrocodone
-
partial agonists, above but lower affinity

N.name
pentazocine mixed agonists-antagonist, k agonist and weak mu antagonist antitussives

codeine Antitussives, weak mu agonist/ natural opium alkaloid/ lower potent effect and side effect
Stopcough
analgesic and cough-suppressant effects, use to relief of moderate pain(only use in severe pain)

Side: constipation and sedation [ Analgesicettǖiàinparaceamol ]

tramadol Antitussives, weak mu agonist, blocks serotonin reuptake

Ch 11 pharmacology of the adrenal glands(corticosteroids) orten

→

the anti-inflammatory action of glucocorticoids (1 and 2)/ pharmacological action

inhibition of 的
PG and leukotriene synthesis/ inhibition of phospholipase A2 production/ decrease transcription of genes
⼀

wxni
coding of cyclooxygenase 2

⼆
decreased capillary permeability(inhibition of histamine release and kinin activity) and inhibition of the effects of

ǛÜ
complement system

i.
carbohydrate metabolism (increase glucose in body)

!
net result Hyperglycemia/ decrease sensitivity to insulin/ diabetes may exacerbated 惡化

lipid metabolism
protein metabolism
Electrolyte, H2o
moon face, buffalo hump, fish mouth with thin limbs Gleorticoids
protein breakdown and mobilization of amino acid, muscle wasting
↓ dtwt
weak mineralocorticoids -> Na H2O retention K+ excretion -> prolonged use -> edema and
… …

metabolism hypertension

calcium metabolism (anti-vitamin D)↑excretion Ca, ↓blood Ca level= osteoporosis

bone Inhibit osteoblast (bone forming cells)/ activate osteoclast (bone resorption cell)

cardiovascular Na+H2O retain cause adrenaline and angiotensin -> chronic -> hypertension
-

skeletal muscle muscle wasting and weakness

CNS euphoria 欣快 insomnia 失眠

GI tract inhibit PG, ↑gastric acid secretion cause peptic ulcer/ ↓immune against H.pylori

blood and lymphoid tissue decrease number of circulating immune cells

immunosuppressive effect inhibit both B, T cell lymphocyte function/ 抑制 hypertension and allergic reaction

anti-inflammatory powerful anti-inflammatory and immunosuppressive/ prevent inflammation

 Glucocorticoid ,

Use:

addison’s disease adrenal failure, replacement therapy

anti-inflammatory Asthma, inflammatory condition, hypersensitivity

Action of glucocorticoids and mineralocorticoids soneè

Short intermediate long mineralocorticoids

Hydrocortisone Prednisolone Dexamethasone Fludrocortisone

Cortisone Methylprednisolone Betamethasone

Triamcinolone
powertulauti.int lammatag .

Ch13 ANS: cholinergic system (autonomic nervous system)

.si synthesis, storage, and fate of the release Ach at cholinergic nerve ending

4.somatte.ci
cholinesterase (ChE): is an enzyme that rapidly hydrolyzed ➔ choline and acetic acid (no therapeutic application)

Muscarinic receptors: (M1-M5) regulate second messengers Nicotinic receptors: (NN, NM) opens the ion channels

wi
nn
M1: gastric glands/ autonomic ganglia/ CNS GI NN: autonomic ganglia/ adrenal medulla/ depolarization cneww )
M2: heart depressant effect ↓ NM: neuromuscular junction/ skeletal muscle contraction Lmusdei
Vesseltb
M3: smooth muscles/ exocrine glands/ endothelial cells

hesialagogue
-

directly acting: 直接打入 Ach 使直接作用於 receptor

choline esters Acetylcholine/ Bethanechol/ Carbachol

_ _
_ chol
_

alkaloids Pilocarpine/ Muscarine (Which of the following receptors is stimulated when pilocarpine is taken?)
Muscarinic
-

Muscarinic action: Pilocarpine increase salivary secretion

cardiovascular s Decrease HR, force of contraction, AV conduction/ vasodilation, low BP MZ

smooth muscle GI tract: ↑gut movement secretions, relaxes the sphincter 括約肌

urinary bladder: increase urinary

M了 ,

Bronchi: contract the bronchial smooth muscle

exocrine glands: parasympathomimetic 擬副交感神經藥 agents stimulate, salivary secretion

hihr rehr n
in " 2
Pilocarpine(drug) Use: glaucoma 青光眼/ sjogren's syndrome / sialagogue↑salivary (cevimeline) Xewstmia
…

t.at
↓
Nicotinic action: larger dose is required M3 agonisthsand Bethaues !
autonomic ganglia tachycardia + increase blood pressure

skeletal muscles paralysis

CNS poor penetration BBB➔IV does not cause central effects

-

indirectly acting: 藉其他物質 anticholinesterase / the amplifier of endogenously released Ach/ reversible and irreversible
-

(ACh gets accumulated at muscarinic and nicotinic sites, in the end: cholinergic effects)

reversible Carbamates Physostigmine/ Pyridostigmine/ Neostigmine tostigmiwe)

Anticholīnesterase
。

)
irreversible . Organophosphate Parathion/ Malathion/ Sarin, tabun
_ _
( athiou )
⼀

-------------------------

Anticholinergic Agents (Cholinergic Receptor Blockers) inhibitpamsympathatic

Antimuscarinic: M1-selective and nonselective (Atropine) (scopolamine: to prevent motion sickness 暈車)

Atropine: treat spastic 痙攣 disorders of GI tract/treat organophosphate poisoning/ suppress respiratory secretion prior to

surgery/treat bradycardia
 pilocaipiwe treatxerostomia
_

Anticholinergic
Atropine:

Use:

mydriatic 散瞳 causes dilatation of eye pupil

antispasmodic relaxes the intestinal and bronchial smooth muscles

pre-anesthetic to stop body secretion and to prevent vagal bradycardia, decrease salivary secretion

CNS stimulation

antidote 解毒 to organophosphate insecticides

CVS initial bradycardia (low dose) ➔tachycardia(therapeutic doses)➔ flushing of the face and

hypotension (high dose)

fodngman
0 Adverse effect: dry mouth (xerostomia)

low doses decrease body secretion, in between rapid heart rate, dilation of the pupil, high dose coma

due anticholinergic action tricyclic antidepressants/ phenothiazines 減少精神分類/ first-generation 1blocker

clonidine lcaganwwmmn
central sympatholytic agent 中樞交感神經藥
algcavsexewstomia ,

Anticholinergic drugs should not be used in patients with glaucoma and elderly males with an enlarged prostate. 說 的 就是 Atropine
Chronic use of xerostomia-producing drugs is associated with a higher incidence of oral candidiasis and dental caries.
-

Ch 14 AUTONOMIC NERVOUS SYSTEM: Adrenergic Agonists (Sympathomimetic Agents) and Receptor Blockers

Adrenergic agonists stimulate sympathetic action

Catecholamines: help the body responds to stress or fight and prepare the body to fight-or-flight reaction

NA (noradrenaline) will further change to adrenaline (epinephrine)

COMT & MAO (reuptake + metabolism) norepinephrine is methylated by COMT and oxidized by MAO

function of adrenergic receptor

tiud Alpha 1 vasoconstrictor action
exam
Alpha 2 contracts some vascular smooth muscle/ inhibit norepinephrine, ACh, insulin release
Blatuor
Beta 1 heart (used in heart failure) improve the contraction state of the failing heart , cavse Tachycardia

branchi-i nne-Vasocowstmcsepiuephrine.at
Beta 2 Vascular and nonvascular smooth muscle relaxation, treat asthma and premature labor 早產(dilation)

direct-acting sympathomimetics (non-selective)

adrenaline arrhythmias and hypertension/ prevent local bleeding/ prolong LA duration ↓toxicity

noradrenaline only activate α1 α2 β1/ ↑BP, HR, FOC, ↓intestinal motility/ side: tachycardia and arrhythmias, vascular
ergic
necrosis and hemorrhages/ treat: anaphylactic shock, local bleeding, hypotension

direct-acting sympathomimetics (selective)

beta1 agonist Dopamine/↑heart FOC, use in heart failure

ot beta2 agonist Formoterol/ dilation, use in bronchial asthma, Delay premature labour/ side: Xerostomia

alpha1 agonist Phenylephrine use for mydriatic and nasal decongestant 去鼻塞/↑BP in hypotension
wnnnr

alpha2 agonist Levonordefrin/ combination with LA(vasoconstrictor effect)

Clonidine/ in CNS↓ sympathetic/ use: management of chronic pain/ side: dry mouth Xewstomia ,

Eazoline)
(α-agonists): naphazoline, oxymetazoline, xylometazoline (topical); pseudoephedrine (oral) and

phenylephrine (oral, topical). /They should not be combined with MAO inhibitors because of risk of hypertensive crisis → fatal.

• If systemically absorbed → may aggravate hypertension

 noradrenaline
Mixed-acting sympathomimetics

Ephedrine pri
alpha and beta agonist with NA release
trent

duration.Acuteasthwa.Anaphylacticshock.LA
↑
wasocontmc)

indirect-acting sympathomimetics

Amphetamine, displaces store catecholamines from Direct acting agonists (adrenaline) ➔ 強大 hypertension

Methamphetamine nerve endings and problems with systemic absorption of adrenaline will be
1 1
3 -
agonist
cocaine blocks NA and dopamine reuptake greater with taking cocaine or Amphetamine-like agents
Vasoconstwt ⼩⼼

hypertension.MAO-rd.BR
,

* Adrenaline can be absorbed systemically after intraoral administration

monoamine oxidase inhibitor

Antidepressants: precipitate a hypertensive crisis

adrenergic antagonists: block the effect of sympathetic stimulation and adrenergic agonist mediate through alpha and beta

receptor/ block the effect of neurotransmitter at receptor

ADRENERGIC RECEPTOR BLOCKERS (Sympatholytics)

☆ 導致
alpha blocker: hypotension provoked reflex Tachycardia
andatenolol
Ǘ non

選
Phenoxybenzamine

Phentolamine
long duration of action/ Use in Pheochromocytoma, controlling the BP

Short duration of action

( Prawsin ) 。

α1 Tamsulosin Used in benign prostatic hypertrophy and hypertensive emergencies and essential
(Tamsulosin )
Prazosin, terazosin hypertension, Minimal orthostatic hypotension. cdmmatic etteet ) ,

α2 Yohimbine -_-
use for erectile dysfunction 勃起功能障礙

Side: hypotension, Tachycardia, 1st dose effect: syncope Prazosinidiuvetic ,

Naihoretention ,

Ch15 SOMATIC NERVOUS SYSTEM: Skeletal Muscle Relaxants

DECREASES the muscle tone. used on muscle spasms, pain, and hyperreflexia. Neuromuscular blocker and Spasmolytics.

Succinylcholine: the only depolarizing muscle relaxant in use today.

Spasmolytics/ antispasmodics: a drug that relieves spasm of smooth/ administered: orally

Benzodiazepines: orally, parenterally, reduce spasm/ MOA: GABA facilitatory action/ short acting drugs/ safely administered in
-

liver failure and in elderly NI

17 B-lactam inhibit cell wall synthesis, inhibit peptidoglycan

(natural penicillin) Bactericidal Gt

Benzyl Penicillin (PnG) 抗 G+, streptococcal (no S.anreus), safe ↑TI, Acid no stable, no orally, limit 抗 G- O2,

shock.at
allergy, anaphylaxis, cross-sensitivity

Penicillin K, VK First choice, acid resistant Pen, acid stable, Less potent than PenG,

orally, treat oral infection anaerobic

(Semisynthetic Penicillin)

Penicillinase resistance penicillin

Cloxacillin Oxacillin, Can 抗 B-lactam bacteria Effect < PenG

flucloxacillin MRSA is common

Broad spectrum penicillin (Aminopenicillin)

Ampicillin, Amoxicillin Wider spectrum, 抗 G+, G- bacilli, longer t1/2 對有 B-lactamase 的 bacteria 無效,敏感

Extended spectrum penicillin, Antipseudomonal penicillin

Piperacillin, Ticarcillin, Wider spectrum, 抗 G+, G- bacilli and 對有 B-lactamase 的 bacteria 無效,敏感,

-
Carbenicillin pseudomonas, treat 對 ampicillin 有抗性的 Bad gut absorbs,

UTI, lung, blood stream G- infection

B-lactamase inhibitors, prevent B-lactam antibiotic 的破壞

Clavulanic acid+ Amoxicillin (oral, parenteral) wider spectrum

i i i .
Tazobactam

Sulbactam+ Ampicillin (parenterally)

☀ PenK and Amoxicillin (only 2 penicillin use in dentistry oral infection)

Penicillin adverse effect: allergic, Pseudomembranous colitis, GI upset, superinfection

(Cephalosporins)/ Bactericidal, broad spectrum, 20% 對 attack by B-lactamases, inactivate by

Cef- or ceph- penicillin 過敏人也對這個過敏, inhibit cell cephalosporinase enzyme/ GI upset, pain,

well peptidoglycan synthesis nephrotoxicity, bleeding (inhibit vit. K)

(Carbapenems)/ High resistant to B-lactamases, IV, treat G+ G- GI upset, allergic, confusion, convulsions

Imipenem
-
aerobes and anaerobes, should add cilastin 才

不會被 renal dihydropeptides broke

(Monobactams)/ resistant to B-lactamases, IV, against G-rods GI upset, hepatitis, blood dyscrasias

0Aztreonam
-
Use to treat 對 penicillin 過敏的人
=
☆
 "

G.
18 Sulphonamides, Quinolones

。
Quinolones: broad spectrum, urinary antiseptics, ↑con in urine, inhibit DNA 合成, bactericidal

1st use

(Nalidixic acid)/ Bactericidal, 抗 G-, low potency in blood Can’t kill pseudomount, CNS head myalgia,
sleepy
(-floxacin) (con↓), only use in easy UTI, GIT infection drowsiness, allergic reaction, hemolytic

anemia

Fluroquinolones (-floxacin)
-

First oral 抗 G-, con in urine> plasma so kill UTI infection Arthropathy, photosensitivity, nephrotoxicity,
← s

(pseudomonas infection), treat 多抗 drug 的 infection, Under 18 and pregnant or lactating woman can’t use

Gonorrhea, respiratory infection, bacterial diarrheas

吃 crip ,

F 中的 Ciprofloxacin Wide spectrum, 抗 G- enteric bacteria, Interaction with theophylline, warfarin,

:
F 中的 Levofloxacin
⼀
typhoid fever, most potent for P.aeruginosa

Combination use, oral, treat respiratory

cyclosporin (↑hepatotoxin)

infection acute bacteria prostatitis, gonorrhea

f.inhibt acteriagrowthyqfowerydbw-o.JP
Sulfonamides Combination use, oral, ↑con bactericidal, 無效 in pus infection, crystalluria, hemolytic

(-sulfa) Folic acid (folate) -> DNA, RNA, protein anemia, kernicterus, 使 warfarin↑ phenytoin

(toxic) can’t metabolism

Sulfisoxazole= treat acute uncomplicated UTI (E. coli)

Sulfadoxine+ pyrimethamine= treat Malaria

Sulfasalazine= treat UC, RA

Trimethoprim (TMP) Combination use, bacteriostatic, high con in

prostatic, vaginal fluid, 經驗治療 upper UTI

pneumonia

Cotrimoxazole (TMP- Combination use, wide spectrum, 抗 G+, G-, /treat G- UTI, respiratory tract infection/ bacteria
.
軟性 下疳
SMZ)= Trimethoprim+ diarrheas/ P.jiroveci infection/ chancroid

sulfamethoxazole è This combination, ↓toxicity, ↓resistance

 cydiunhibtprotein.G-aerobwostrawbe.mg
myc.in ,

Ch 19

Aminoglycosides, 抑 30s, ↓translation, most are bacteristatic

Against (kill) G- aerobic/ ↑ dose fast kill/ one-daily Reversible 腎毒, ototoxicity, cross placenta-> fetal nerve damage,

dosing neuromuscular blockade, allergic

Streptomycin 1st drug for tuberculosis, use& tetracycline → 齉

Lung

Gentamicin
-
commonest use AMG, use & amoxicillin to prevent endocarditis, topical use on G- skin, eye, ear

Amikacin Widest spectrum, Nosocomial infection 院內感染

Neomycin Topical use, orally, treat Hepatic coma ↑ nephrotoxic, inhibit intestinal flora
ww

Ch 20

Tetracyclines (-cycline), 抑 30s

Doxycline, minocycline, Use in chronic periodontist refractory cross placenta, avoid pregnant, child ↓8y

Tigecycline

ftp.
Chloramphenicol (-ithro), 抑 50s
chlora
Use inserioeus
derious infection Bone marrow suppression 抑制 gray body, cross placenta
↑ conbactericidal
⼀点些機 以 全部 直球 ↓ 症
secreted in bile, milk/ pancytopenia

Ch 21 inhibit translocation

Macrolides (-thromycin), 抑 50s Gt

Pregnancycanuse
Erythromycin ↓攻 Narrow, short duration, acid unstable, Ototoxicity, hepatic toxic, Jaundice , inhibit P 450

Claritromycin First line for AIDs patient, long acting, acid stable, H.pylori

Azithromycin Wider spectrum, single daily use, endocarditis

Lincosamides, 抑 50s

ckvi.at
Clindamycin Good con in bone well into gingival fluid for Can’t use with Erythromycin, "

periodontitis/ treat G+, G- anerobic Pseudomembranous colitis, server diarrhea

by clostridium difficile

Ch 22

Cell wall inhibition

Vancomycin Bactericidal, 抗 G+, treat sepsis or

endocarditis cause by MRSA

Damage DNA

Metronidazole
n rss n o e e
Bactericidal, 抗 anaerobic, treat colitis
.e e
a re
Disulfiram-like effect 戒酒樣症狀, avoid
⾺ 思 在 Metro 上 醉 ,

alcohol

Antituberculosis: problem drug resistance/ isoniazid, rifampin, ethambutol, pyrazinamide

Rifampin First line antituberculosis, Cause red, orange saliva

Ch 23 antifungal

Ergosterol: fungi membrane

Polygene antibiotic

Amphotericin B (AMB) Broad spectrum, systemic infection, MOA: ↑ permeability, form pore lead K+ loss

most toxic in IV, -> cell death

Nystatin Treat oral candidiasis

Antimetabolites

fiii
Flucytosine Treat AIDs candidiasis, 5FU 干擾 fungal DNA synthesis

Azoles (broad spectrum) inhibit ergosterol form

skn Acidicewironmeut
Ketoconazole Treat Dermatophytosis/ blocks P450
-

↓ steroid, testosterone, estrogen synthesis

tawrs absorption
block P 450 metabdism ,

(imidazole)
-
metabolism/less toxic < AMB

Fluconazole (Triazoles) Treat Oropharyngeal, esophageal candidiasis Interact with Erythromycin

Allylamine, inhibit ergosterol form

Terbinafine Fungicidal,

Echinocandins

Caspofungin 介 glycogen

Heterocyclic benzofuran

Griseofulvin Fungistatic, not against candida, 介 mitosis

沵路 ⽤

Ch24 Antiviruses

Antiviruses drug (nonretroviral)

Acyclovir
-
Treat gingivostomatitis, herpes labialis, herpes simplex (most potent), ulcer in mouth
 Ch25-27 blood drug

Anticlotting drug: (prevent) anticoagulant/ antiplatelet/ (dissolve) thrombolytics

Heparin Bind ATlll-> inactive thrombin and FXa, Measure: thrombocytopenia time
☆
Antidote Protamine
Sultate ,
immediately treat 最快, pregnancy 可用, Bleeding, hypersensitivity, thrombocytopenia

Warfarin Inhibit vit.K epoxide reductase, interfere clotting Pregnancy 不可用, narrow therapeutic index,

Antidote U.tk factor/ fors

chronic anticoagulation inhibit CYP 450↓ metabolism/ hemorrhage/
ru

interaction with antibiotic-> ↓K

Lepirudin (IV), Direct thrombin inhibitors, bind thrombin’s Bleeding anemia, bleeding
=
→
最嚴重
Dabigatran (oral) active site, use in Dabigatran, prevent stroke, No antidote, avoid aspirin and NSAIDs

thrombocytopenia

Rivaroxaban,
_
Xa inhibitors, use in thrombosis, embolism,
_

Apixaban
=
prevent stroke

Antiplatelet drug

Aspirin (low dose) TXA2 thromboxane synthesis inhibitor, ↓myocardial infarction

Dipyridamole Phosphodiesterase inhibitor, should + Aspirin or warfarin to prophylaxis(prevent) thromboembolic

Clopidogrel ADP (adenosine diphosphate) receptor inhibitor

Abciximab
_
(GP) IIb/ IIIa receptor inhibitor
_ _

Thrombolytic 溶酸劑, agents (dissolve plug)

Tissue plasminogen activator/ use in acute Bleeding, cerebral hemorrhage

streptokinase.EU/o.urnParcetamdYverdosehpatocel
myocardial infraction, thromboembolism

Hemostatic agents 止 bleeding 要 clotting

Vit K (systemic) Fat soluble, 合 clotting factors, prevent baby bleed disease

Aminocaproic acid, Tranexamic acid Antiplasmin drug, Antifibrinolytic

Antidotes

Drug (Potent), (Antidote for)

Aminocaproic acid, Tranexamic acid Fibrinolytic state

Vitamin K1 Warfarin

Protamine sulfate Heparin

N-acetylcysteine Acetaminophen
ularnecrosis

LA
Ester Amide
Procaine 其它
Chloroprocaine
Tetracaine

cocaiue.lt
pical alkrgi c)
,

Rapidly (
Rardyáhgic ,
intense
longerduration
longerlastinganaesthesia)
livertoxicity