INTRODUCTION:

These polymers used for modified release. Modified release systems³ are designed to reduce the frequency of dosing by modifying the rate of drug absorption has been available from many years. This type of release dosage⁴ forms is far better than the conventional release dosage forms. Mucoadhesive⁵ are synthetic or natural polymers that will interact with the mucus layer which is present in the body at buccal cavity, and gastric mucosal layers. Antibiotics⁶can be used for preparation of tablets.

The specific approach to their use is dependent on the individuals affected and stage of the disease. Researchers⁷ are developing customized picoparticles the size of molecules that can deliver drugs directly to diseased cells in your body. Antibiotics⁸ are also used to treat this disease. Oral modified⁹ drug delivery systems can be classified in to two broad groups Single Unit dosage forms and multiple unit dosage forms. The advances¹⁰ and progress made by pharmaceutical industry have greatly contributed in terms of treatment of disease, thereby enhancing the quality of life. Mucilage and Gums are hydrophilic polysaccharides¹¹. Smoking is bad for your health¹².

A drug is any substance (other than food that provides nutritional support) that, when inhaled, injected, smoked, consumed, absorbed via a patch on the skin, or dissolved under the tounge causes a temporary physiological (and often psychological) change in the body¹³.

Venous thrombus may be a grume (thrombus) that forms inside a vein. A standard form of occlusion may be a deep vein thrombosis (DVT) that may be a grume within the deep veins of the leg. If the clot breaks off (embolizes) and flows towards the lungs, it will become a embolism (PE), a grume within the lungs¹⁴

Arterial occlusion may be a grume in an artery, which might be terribly serious as a result of it can stop blood reaching necessary organs¹⁵

Deep vein occlusion (DVT), is that the formation of a grume in a very deep vein, most ordinarily the legs¹⁶

SIGNS AND SYMPTOMS:

The signs and symptoms of deep vein thrombosis (DVT) may be related to DVT itself or to pulmonary embolism (PE). Both DVT and PE can cause serious, possibly life-threatening complications if not treated.

Deep Vein Thrombosis: Only about half of the people who have DVT have signs or symptoms. These signs and symptoms occur in the leg affected by the deep vein clot.

They include:

· Swelling of the leg or along a vein in the leg

· Pain or tenderness in the leg, which you may feel only when standing or walking

· Increased warmth in the area of the leg that’s swollen or in pain Red or discolored skin on the leg¹⁷

Fig1: Normal anatomy and deep vein thrombosis

CAUSES:

DVT occurs most commonly in people age 50 and over. It’s also more commonly seen in people who:

· are overweight or obese

· are pregnant or in the first six weeks postpartum

· have a family history of DVT

· have a catheter placed in a vein

· have an injury to a deep vein

· have recently had surgery

· take certain birth control pills or are receiving hormone therapy

· smoke, especially if also overweight is present

· stay seated for long periods of time, such as during a long plane ride

· have sustained a recent fracture involving the pelvis, hips, or lower extremities¹⁸

PATHOPHYSIOLOGY:

Fig 2: Deep veins of the leg

Deep thrombosis sometimes arises within the lower extremities. Most DVTs kind within the calf veins, notably within the skeletal muscle sinusoids and cusps of the valves.

Venous valves are avascular, which, in conjunction with reduced flow of oxygenated blood in veins, predisposes the endothelium to be hypoxemic. The endothelium around valves responds by expressing adhesion molecules that attract leukocytes. These cells transfer tissue factor to the endothelium, which can complex with activated factor VII to begin the coagulation cascade via the extrinsic pathway. The main component of these venous thrombi is fibrin (as product of coagulation cascade) and red blood cells, which get trapped in the clot. Platelets also contribute, but to a lesser extent.

The skeletal muscle pump helps prevent DVT by moving blood past the valves (i.e. reducing venous stasis), which washes away activated clotting factors that can otherwise propagate the initial thrombus.

If a clot forms and does not resolve (see below), it will extend proximally into the popliteal and femoral veins (“proximal veins”). 25% of calf DVTs will extend proximally within 7 days. While calf DVTs are usually asymptomatic and do not give rise to significant PEs, proximal DVTs are more likely symptomatic and can embolize to form dangerous PEs¹⁹

DIAGNOSIS:

Ultrasound:

A wand like device (transducer) placed over the part of your body where there's a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot might be visible in the image.

Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to check for a new one.

Blood test:

Almost all people who develop severe deep vein thrombosis have an elevated blood level of a substance called D dimer.

Venography:

A dye is injected into a large vein in your foot or ankle. An X-ray creates an image of the veins in your legs and feet, to look for clots. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis.

CT or MRI scans:

Either can provide visual images of your veins and might show if you have a clot. Sometimes these scans performed for other reasons reveal a clot²⁰

TREATMENT:

Anticoagulation:

Anticoagulation: This prevents further coagulation, but does not act directly on existing clots, is the standard treatment for DVT. Balancing risk vs. benefit is important in determining the duration of anticoagulation, and three months is generally the standard length of treatment²¹

Clot busters:

If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor might prescribe drugs that break up clots quickly, called clot busters or thrombolytics.

These drugs are either given through an IV line to break up blood clots or through a catheter placed directly into the clot. These drugs can cause serious bleeding, so they're generally reserved for severe cases of blood clots²²

Compression Stockings:

Need to wear graduated compression stockings to get rid of leg swelling. The swelling is often because the valves in the leg veins are damaged or the vein is blocked by the DVT.

Most compression stockings are worn just below the knee. These stockings are tight at the ankle and become looser as they go up the leg. This causes gentle pressure (compression) on your leg²³

Filters:

If you can't take medicines to thin your blood, you might have a filter inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.

CONCLUSION:

Thrombosis is that the formation of a grume within a vessel, obstructing the flow of blood through the cardiovascular system. Once a vessel (a vein or artery) is skinned, the body uses platelets (thrombocytes) and protein to create a grume to stop blood loss. Venous thrombus may be a grume (thrombus) that forms inside a vein. A standard form of occlusion may be a deep vein thrombosis (DVT) that may be a grume within the deep veins of the leg. DVT occurs most commonly in people age 50 and over. Ultrasound- A wand like device (transducer) placed over the part of your body where there's a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. Anticoagulation: which prevents further coagulation, but does not act directly on existing clots, is the standard treatment for DVT Balancing risk vs. benefit is important in determining the duration of anticoagulation, and three months is generally the standard length of treatment.

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Received on 10.09.2018 Accepted on 28.10.2018

Asian J. Pharm. Res. 2018; 8(4): 255-258.

DOI: 10.5958/2231-5691.2018.00044.8