Gilead -Topics in Human Pathophysiology

Fall 2009 Drug Safety and Public Health

Blood

• Consists of:– Plasma– Erythrocytes– Leukocytes– platelets– thrombocytes

Figure 7.8

Blood Production and Disorders

• Overview of blood production• Disorders of erythrocytes• Disorders of platelets• Disorders of leukocytes

Blood Cell Production

• Occurs in bone marrow• Also called hemopoiesis (hematopoiesis)• Stem cells are rapidly dividing• Requires iron, Vitamin B12 (and other B

vitamins), other trace minerals, vitamins• Controlled by chemical messengers• Has 5 lines of production

Blood Cell Formation Slide 13

Stem cells arelocated in redbone marrow

Stem cells multiply andbecome specialized Mature blood cells

Erythroblast

Myeloblast

Nucleuslost

Stem cell

Monoblast

Lymphoblast

Megakaryoblast Megakaryocyte Platelets

Lymphocyte

Monocyte

Basophil

Eosinophil

Neutrophil

Granularleukocytes

Agranularleukocytes

Whitebloodcells

Erythrocyte(red blood cell)

Blood Disorders

• Anemias• Thrombocytopenia• Leukocytopenia, leukocytosis• Clotting factor disorders• Lipid disorders

• Structure and function• Ischemic Heart Disease• Lexiscan, Ranexa• Heart Failure

Heart and Disease

Figure 8.7b

Cardiac Cycle

• http://www.youtube.com/watch?v=D3ZDJgFDdk0&feature=rec-HM-rn

Figure 8.14

Figure 8.15

Figure 8.11

Ischemic Heart Disease

• Coronary artery disease• Myocardial ischemia• Myocardial hypoxia• Myocardial infarct• Myocardial necrosis

Coronary Angiogram

From wikipedia

Risk Factors for Cardiovascular Disease

Age

Male sex

Heredity

Smoking

Diabetes mellitus

Hypertension

High cholesterol

Obesity

Lack of exercise

Diagnosis and Treatment of Ischemic Heart Disease

• Diagnosis– BP monitoring– Symptoms– ECG– Angiogram– Stress Test

– Nuclear myocardial perfusion tests

Lexiscan

• For myocardial perfusion imaging (MPI)• A2A adenosine receptor agonist• Vasodilates coronary arteries as if exercising• Injected into blood stream prior to gamma

camera scan• Can give a good indication of myocardial

perfusion

Diagnosis and Treatment of Ischemic Heart Disease

• Treatment– Coronary bypass

surgery– Angioplasty– Stents– Cholesterol lowering

agents– Anticoagulents– Antianginal

medications

Ranexa

• For angina• Probably changes ion channels in walls

of blood vessels serving the heart• Can be taken with other anti-anginal

meds• Very effective

Congestive Heart Failure

• Heart becomes weak• Blood backs up in veins and capillaries• Fluid excess in tissues• Symptoms include shortness of breath,

edema, difficulty breathing (especially when lying down,) difficulty exercising

Congestive Heart Failure

Congestive Heart Failure

http://www.bangkokhospital.com/images/procedures/Congestive_Heart_Failure.jpg